Individual provider Active NPI

Julianne Waltenburg, OTR/L

  • Pediatric Occupational Therapist
  • Seattle, WA
National Provider Identifier
1780101899
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT61138507 Issued in WA
Practice address
4636 E Marginal Way S
Seattle, WA 98134-2382
Phone
(206) 763-0352
NPI assigned
Aug 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT61138507 WA Primary

Addresses

Primary practice location

4636 E Marginal Way S
Seattle, WA 98134-2382

Mailing address

1122 N 6TH St Apt 17
Tacoma, WA 98403-1650
Phone (775) 741-0485

Other practice location 1

4600 Kietzke Ln Ste M246
Reno, NV 89502-5000
Phone (775) 200-0935

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
OT61138507WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith Shatto CurrentSince Mar 16, 2021 Accepting new patients

Locations

4636 E Marginal Way S
Ste B100
Seattle, WA 98134
Phone (206) 763-0352

4636 E Marginal Way S
Seattle, WA 98134
Phone (206) 291-8710

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": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1780101899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 N 6TH ST APT 17",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984031650",
            "telephone_number": "775-741-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 E MARGINAL WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981342382",
            "telephone_number": "206-763-0352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Kietzke Ln Ste M246",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895025000",
            "country_code": "US",
            "telephone_number": "775-200-0935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTENBURG",
        "first_name": "JULIANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT61138507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.