Individual provider Active NPI

Stacey Reiko Leong Minson, DOT

  • Occupational Therapist
  • Marysville, WA
National Provider Identifier
1699197194
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60441895 Issued in WA
Practice address
9802 48TH Dr NE
Marysville, WA 98270-8100
Phone
(808) 232-8263
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X OT60441895 WA Primary

Addresses

Primary practice location

9802 48TH Dr NE
Marysville, WA 98270-8100

Mailing address

1809 NE 172ND St
Shoreline, WA 98155-6034

Other names 1

  • Stacey Leong Minson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170914003377 WA Practitioner - Occupational Therapist in Private Practice 5395019350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Wa PCGroup PAC ID 4284015330, 48 clinicians

Practice addresses (Care Compare)

2450 Newport Way NW
Issaquah, WA 98027-4046
Phone (425) 225-7282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60441895WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Wa, PC Occupational Therapist CurrentSince Jan 1, 2025 Accepting new patients
Select Rehabilitation, LLC Occupational Therapist Past Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

4503 S Freya St
Spokane, WA 99223
Phone (509) 472-8752

Organizations & group practices 2

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": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1699197194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 NE 172ND ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981556034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9802 48TH DR NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708100",
            "telephone_number": "808-232-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINSON",
        "first_name": "STACEY",
        "middle_name": "REIKO LEONG",
        "credential": "DOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60441895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "LEONG MINSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.