Active NPI
Bruce A Huddleston, OTR/L
- Occupational Therapist
- Pasco, WA
National Provider Identifier
1770673089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 00003987
- Practice address
- 4608 W Nixon St
Pasco, WA 99301-2834 - Phone
- (239) 770-7612
- NPI assigned
- Oct 15, 2006
- Last updated
- Jan 16, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 00003987 | WA | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 8373 | FL |
Addresses
Primary practice location
4608 W Nixon St
Pasco, WA 99301-2834
Mailing address
4608 W Nixon St
Pasco, WA 99301-2834
Phone (239) 770-7612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891065100 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8373 | FL | MD | Emergency Medicine Physician |
| 00003987 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295136000000",
"number": "1770673089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4608 W NIXON ST",
"city": "PASCO",
"state": "WA",
"postal_code": "993012834",
"telephone_number": "239-770-7612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4608 W NIXON ST",
"city": "PASCO",
"state": "WA",
"postal_code": "993012834",
"telephone_number": "239-770-7612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDLESTON",
"first_name": "BRUCE",
"middle_name": "A",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-15",
"last_updated": "2011-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "00003987",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "8373",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891065100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasco, WA
- John Allan Hornell, MD
- Stacey Lee Horspool, LMP
- House, Lee, Mast, McDonald and Nelson, PC (Advanced Pediatric Dentistry and Orthodontics of Pasco)
- Nicholas Samuel Howard, DMD, MBA
- Shannon L Howlett, PHARMD
- Carrie L Huie Pascua, MS
- Patricia E Huizar
- Erin Hultgrenn, RN
- George Edward Humes
- Patricia Ann Hussey, N.P.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.