Individual provider Active NPI

Janna Stombaugh, OTR/L

  • Occupational Therapist
  • Snoqualmie, WA
National Provider Identifier
1750588315
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 00004562 Issued in WA
Practice address
9575 Ethan Wade Way SE
Snoqualmie, WA 98065-9577
Phone
(425) 831-2376
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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 OT 00004562 WA Primary

Addresses

Primary practice location

9575 Ethan Wade Way SE
Snoqualmie, WA 98065-9577

Mailing address

36137 307TH Ave SE
Enumclaw, WA 98022-7662
Phone (208) 660-0414

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 00004562WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 4 King County Washington Past Accepting new patients

Organizations & group practices 1

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1750588315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36137 307TH AVE SE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980227662",
            "telephone_number": "208-660-0414",
            "fax_number": "425-831-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9575 ETHAN WADE WAY SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659577",
            "telephone_number": "425-831-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOMBAUGH",
        "first_name": "JANNA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 00004562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.