Active NPI
Yvette Phan
- Occupational Therapist
- Tacoma, WA
National Provider Identifier
1710468772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 60822577
- Practice address
- 1649 E 72ND St
Tacoma, WA 98404-5402 - Phone
- (253) 472-9027
- NPI assigned
- Aug 27, 2018
- 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 | 60822577 | WA | Primary |
Addresses
Primary practice location
1649 E 72ND St
Tacoma, WA 98404-5402
Mailing address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
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 |
|---|---|---|---|
| 60822577 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535328000000",
"number": "1710468772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972224628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1649 E 72ND ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984045402",
"telephone_number": "253-472-9027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "YVETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-27",
"last_updated": "2018-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "60822577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.