Individual provider Active NPI

Chris John Spaccarotelli

  • Occupational Therapist
  • Lacey, WA
National Provider Identifier
1740033091
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00001700 Issued in WA
Practice address
4200 6TH Ave SE
Suite 201
Lacey, WA 98503-1042
Phone
(360) 459-8311
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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 OT00001700 WA Primary

Addresses

Primary practice location

4200 6TH Ave SE
Suite 201
Lacey, WA 98503-1042

Mailing address

4200 6TH Ave SE
Suite 201
Lacey, WA 98503-1042
Phone (360) 459-8311

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
OT00001700WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1740033091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 6TH AVE SE",
            "address_2": "SUITE 201",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031042",
            "telephone_number": "360-459-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 6TH AVE SE",
            "address_2": "SUITE 201",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031042",
            "telephone_number": "360-459-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPACCAROTELLI",
        "first_name": "CHRIS",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00001700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.