Individual provider Active NPI

Tracy Leeanne Chmielewski, OT

  • Occupational Therapist
  • Black Diamond, WA
National Provider Identifier
1740824994
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60064456 Issued in WA
Practice address
31135 228TH Ave SE
Black Diamond, WA 98010-1708
Phone
(253) 373-7750
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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 OT60064456 WA Primary

Addresses

Primary practice location

31135 228TH Ave SE
Black Diamond, WA 98010-1708

Mailing address

20612 SE 294TH Way
Kent, WA 98042-6849
Phone (206) 915-0494

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
OT60064456WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1740824994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20612 SE 294TH WAY",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980426849",
            "telephone_number": "206-915-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31135 228TH AVE SE",
            "city": "BLACK DIAMOND",
            "state": "WA",
            "postal_code": "980101708",
            "telephone_number": "253-373-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMIELEWSKI",
        "first_name": "TRACY",
        "middle_name": "LEEANNE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60064456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Diamond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.