Individual provider Active NPI

Erica Kaylin Gray, COTA/L

  • Occupational Therapy Assistant
  • Port Orchard, WA
National Provider Identifier
1932788593
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
61379515 Issued in WA
Practice address
5455 Converse Ave SE
Port Orchard, WA 98367-7809
Phone
(360) 874-6400
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.005553 IL
Occupational Therapy Assistant 224Z00000X 61379515 WA Primary

Addresses

Primary practice location

5455 Converse Ave SE
Port Orchard, WA 98367-7809

Mailing address

11849 Majestic LN NW Apt 103
Silverdale, WA 98383-7934
Phone (618) 910-0549

Other names 1

  • Erica Kaylin Behl Former name

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
057.005553ILMDOccupational Therapy Assistant
61379515WAMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1932788593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11849 MAJESTIC LN NW APT 103",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837934",
            "telephone_number": "618-910-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 CONVERSE AVE SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677809",
            "telephone_number": "360-874-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ERICA",
        "middle_name": "KAYLIN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005553",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "61379515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "BEHL",
            "middle_name": "KAYLIN",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.