Elijah Occenola

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

4040 Orchard St W Ste 100
Fircrest, WA 98466-6610

Phone

(253) 270-0527

NPI assigned

Jan 20, 2025

Last updated

Jan 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1942011861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7806 ONYX CT SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984983946",
            "telephone_number": "253-327-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 ORCHARD ST W STE 100",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666610",
            "telephone_number": "253-270-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCCENOLA",
        "first_name": "ELIJAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michelle Ost, MD
• Stacey Park, PHD

• Physical Therapy Assistant in Fircrest, WA
• Providers in Fircrest, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.