Individual provider Active NPI

Nicole Tatiana Hawe, OTR/L

  • Occupational Therapist
  • Bonney Lake, WA
National Provider Identifier
1740413715
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60091437 Issued in WA
Practice address
19820 Sr 410 E
Suite 201
Bonney Lake, WA 98391-6377
Phone
(253) 863-7510
Fax
(253) 863-5970
NPI assigned
Aug 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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 OT60091437 WA Primary

Addresses

Primary practice location

19820 Sr 410 E
Suite 201
Bonney Lake, WA 98391-6377

Mailing address

PO Box 2170
Sumner, WA 98390-0480
Phone (253) 840-2313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091003000031 WA Practitioner - Occupational Therapist in Private Practice 9234275355 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60091437WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 14, 2022 Accepting new patients
Multicare Health System Occupational Therapist CurrentSince Oct 14, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Apple Physical Therapy LLC Occupational Therapist Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 319
Gig Harbor, WA 98335
Phone (253) 530-8328

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

Organizations & group practices 4

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": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1740413715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2170",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983900480",
            "telephone_number": "253-840-2313",
            "fax_number": "253-840-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19820 SR 410 E",
            "address_2": "SUITE 201",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916377",
            "telephone_number": "253-863-7510",
            "fax_number": "253-863-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWE",
        "first_name": "NICOLE",
        "middle_name": "TATIANA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60091437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.