Individual provider Active NPI

Samantha Louise Lyman, OTD, OTR/L

  • Occupational Therapist
  • Renton, WA
National Provider Identifier
1679204416
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61320007 Issued in WA
Practice address
1700 Edmonds Ave NE Ste B
Renton, WA 98056-2713
Phone
(425) 747-4004
NPI assigned
Jun 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT61320007 WA Primary

Addresses

Primary practice location

1700 Edmonds Ave NE Ste B
Renton, WA 98056-2713

Mailing address

1700 Edmonds Ave NE Ste B
Renton, WA 98056-2713
Phone (425) 747-4004

Other names 1

  • Samantha Louise Abrass Former name

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
OT61320007WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kindering Center PastSince Dec 7, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1679204416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 EDMONDS AVE NE STE B",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562713",
            "telephone_number": "425-747-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EDMONDS AVE NE STE B",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562713",
            "telephone_number": "425-747-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "SAMANTHA",
        "middle_name": "LOUISE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61320007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "ABRASS",
            "middle_name": "LOUISE",
            "credential": "OTD, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.