Active NPI
Charlene Marie Desautel, PT
- Physical Therapist
- Grand Coulee, WA
National Provider Identifier
1881936052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00006815
- Practice address
- 411 Fortuyn Rd
Grand Coulee, WA 99133-8718 - Phone
- (509) 633-1911
- Fax
- (509) 633-3644
- NPI assigned
- Mar 26, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00006815 | WA | Primary |
Addresses
Primary practice location
411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Mailing address
411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone (509) 633-1911
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00006815 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 | Past | Accepting new patients |
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.
-
- Critical Access Hospital
- Grand Coulee, WA
- NPI 1184844185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1881936052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 FORTUYN RD",
"city": "GRAND COULEE",
"state": "WA",
"postal_code": "991338718",
"telephone_number": "509-633-1911",
"fax_number": "509-633-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 FORTUYN RD",
"city": "GRAND COULEE",
"state": "WA",
"postal_code": "991338718",
"telephone_number": "509-633-1911",
"fax_number": "509-633-3644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAUTEL",
"first_name": "CHARLENE",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-26",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00006815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Coulee, WA
- Jacob Petersen Chaffee, MD
- Cheney Owl Pharmacy Inc
- City of Grand Coulee
- Kathleen Kelly Cohen, D.O.
- Dee Deife, BA
- Douglas, Grant, Lincolc and Okanogan Couties Public Hosp. Dist. #6
- Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6
- Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6
- Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6
- Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.