Active NPI
Amber Odo, PT
- Physical Therapist
- Puyallup, WA
National Provider Identifier
1912624412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61328945
- Practice address
- 1007 39TH Ave SE
Puyallup, WA 98374-2192 - Phone
- (253) 435-3170
- NPI assigned
- Oct 25, 2022
- 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 | 61328945 | WA | Primary |
Addresses
Primary practice location
1007 39TH Ave SE
Puyallup, WA 98374-2192
Mailing address
3209 E F St
Tacoma, WA 98404-1630
Phone (808) 859-9780
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1007 39TH Ave SE
Puyallup, WA 98374-2192
Phone (253) 435-3100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61328945 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
1007 39th Ave SE
Puyallup, WA 98374
Phone (253) 435-3100
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
dba Everett Medical Center
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670457600000",
"number": "1912624412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3209 E F ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984041630",
"telephone_number": "808-859-9780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 39TH AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983742192",
"telephone_number": "253-435-3170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODO",
"first_name": "AMBER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-25",
"last_updated": "2022-12-08",
"certification_date": "2022-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "61328945",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1007 39th Ave SE",
"city": "Puyallup",
"state": "WA",
"country_code": "US",
"postal_code": "983742192",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Puyallup, WA
- Gary Lee Obrien, LMHC CDP RN
- Occupational Health Centers of Washington, P.S. (Concentra Medical Centers)
- Occupational Health Centers of Washington, P.S. (Concentra Medical Centers)
- Madeline Ocel
- Lori Odagiri
- Odyssey Therapeutics
- Paul C Ogu Sr., BS PHARM
- Meeae Oh
- Mary Louise Ohlsen
- Oikos Eye Care, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.