Active NPI
Nola Syfert Kundu, CTRS
- Recreation Therapist
- Everett, WA
National Provider Identifier
1871523712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- RE00000304
- Practice address
- 916 Pacific Ave
Everett, WA 98201-4147 - Phone
- (425) 258-8750
- NPI assigned
- Jul 4, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | RE00000304 | WA | Primary |
Addresses
Primary practice location
916 Pacific Ave
Everett, WA 98201-4147
Mailing address
9631 105TH Ave NE
Lake Stevens, WA 98258-8971
Phone (360) 653-4780
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 |
|---|---|---|---|
| RE00000304 | WA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871523712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9631 105TH AVE NE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982588971",
"telephone_number": "360-653-4780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 PACIFIC AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014147",
"telephone_number": "425-258-8750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNDU",
"first_name": "NOLA",
"middle_name": "SYFERT",
"name_prefix": "Ms.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "WA",
"license": "RE00000304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.