Active NPI
Kaela Dewan, OTR/L
- Occupational Therapist
- Pullman, WA
National Provider Identifier
1679934541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT60628133
- Practice address
- 1620 SE Summit CT
Pullman, WA 99163-5540 - Phone
- (509) 332-5106
- NPI assigned
- Mar 18, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT60628133 | WA | Primary |
Addresses
Primary practice location
1620 SE Summit CT
Pullman, WA 99163-5540
Mailing address
709 W Rednour St
Oakesdale, WA 99158-5000
Phone (509) 499-6051
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT60628133 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1679934541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 W REDNOUR ST",
"city": "OAKESDALE",
"state": "WA",
"postal_code": "991585000",
"telephone_number": "509-499-6051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 SE SUMMIT CT",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635540",
"telephone_number": "509-332-5106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWAN",
"first_name": "KAELA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-18",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT60628133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pullman, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.