Active NPI
Gretchen Reynolds
- Behavior Technician
- Covington, WA
National Provider Identifier
1851784730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 27023 164TH Ave SE
Covington, WA 98042-8241 - Phone
- (425) 293-5158
- NPI assigned
- Mar 16, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P160293883 | WA | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
27023 164TH Ave SE
Covington, WA 98042-8241
Mailing address
22512 SE 277TH PL
Maple Valley, WA 98038-5117
Phone (425) 293-5158
Other practice location 1
816 S 216th St
Des Moines, WA 98198-6331
Phone (206) 824-3663
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 |
|---|---|---|---|
| P160293883 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1851784730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22512 SE 277TH PL",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980385117",
"telephone_number": "425-293-5158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27023 164TH AVE SE",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980428241",
"telephone_number": "425-293-5158"
}
],
"practiceLocations": [
{
"address_1": "816 S 216th St",
"address_purpose": "LOCATION",
"city": "Des Moines",
"state": "WA",
"postal_code": "981986331",
"country_code": "US",
"telephone_number": "206-824-3663",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYNOLDS",
"first_name": "GRETCHEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-16",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P160293883",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.