Individual provider Active NPI

Lane M Soden, OT

  • Occupational Therapist
  • Federal Way, WA
National Provider Identifier
1669709374
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT16767 Issued in FL
Practice address
29515 4TH Ave S
Federal Way, WA 98003-3667
Phone
(253) 230-5554
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT60091796 WA
Occupational Therapist 225X00000X OT16767 FL Primary

Addresses

Primary practice location

29515 4TH Ave S
Federal Way, WA 98003-3667

Mailing address

29515 4TH Ave S
Federal Way, WA 98003-3667
Phone (253) 230-5554

Other identifiers 1

IdentifierTypeStateIssuer
7018518MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT60091796WAMDSpecialist
OT16767FLMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1669709374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29515 4TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033667",
            "telephone_number": "253-230-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29515 4TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033667",
            "telephone_number": "253-230-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODEN",
        "first_name": "LANE",
        "middle_name": "M",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "OT60091796",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7018518",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.