Individual provider Active NPI

Nola Syfert Kundu, CTRS

  • Recreation Therapist
  • Everett, WA
National Provider Identifier
1871523712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
License
RE00000304 Issued in WA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
RE00000304WAMDRecreation 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.

Verify at the official NPI Registry.