Life Span Occupational Therapy LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

LIFE SPAN OCCUPATIONAL THERAPY LLC

Practice address

1240 Ruddell Rd SE
Lacey, WA 98503-5747

Phone

(425) 395-6006

Fax

(360) 918-8274

NPI assigned

Apr 19, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacqueline Watson, OTNPI 1114129491

Title

Owner

Phone

(425) 395-6006

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Watson, OTR/L

  • Occupational Therapist
  • Lacey, WA
  • NPI 1114129491
  NPD Authorized official

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1770164964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4314",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874020",
            "telephone_number": "425-395-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 RUDDELL RD SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035747",
            "telephone_number": "425-395-6006",
            "fax_number": "360-918-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN OCCUPATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-395-6006",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HEALTH",
            "identifier": "OT60105178",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• LG Psychological Services PLLC
• Bojia Li, M.D.
• Heather Liddell, C.O.T.A.
• Seff Fenrir Liddell, LMHCA
• Tom Michael Liederbach, D.PH., R.PH.
• Deanna Marie Limas, L.M.P
• Sandra Roswitha Lindell, PMHNP-BC
• Kaman Lindgren, RN
• Debra Ann Lindsay, FNP-C
• Yathindran J Lingam-Nattamai, DDS

• All providers in Lacey, WA
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.