Active NPI
Cathryn J Bouchard
- Recreation Therapist
- Spokane, WA
National Provider Identifier
1932617982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- CG60789442
- Practice address
- 3754 W Indian Trail Rd
Spokane, WA 99208-4736 - Phone
- (509) 328-7041
- Fax
- (509) 328-7582
- NPI assigned
- Jan 11, 2018
- 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 | CG60789442 | WA | Primary |
Addresses
Primary practice location
3754 W Indian Trail Rd
Spokane, WA 99208-4736
Mailing address
3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone (509) 328-7041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CG60789442 | Other | WA | WASHINGTON STATE DEPT OF HEALTH |
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 |
|---|---|---|---|
| CG60789442 | WA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521504000000",
"number": "1932617982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3754 W INDIAN TRAIL RD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992084736",
"telephone_number": "509-328-7041",
"fax_number": "509-328-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3754 W INDIAN TRAIL RD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992084736",
"telephone_number": "509-328-7041",
"fax_number": "509-328-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHARD",
"first_name": "CATHRYN",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-11",
"last_updated": "2018-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "WA",
"license": "CG60789442",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPT OF HEALTH",
"identifier": "CG60789442",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.