Individual provider Active NPI

Cynthia Marie Larsen, OTR/L

  • Occupational Therapist
  • Lynnwood, WA
National Provider Identifier
1952653768
Registry record updated Dec 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 00001530 Issued in WA
Practice address
19231 36TH Ave W Ste K
Lynnwood, WA 98036-5763
Phone
(425) 774-9564
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 00001530 WA Primary

Addresses

Primary practice location

19231 36TH Ave W Ste K
Lynnwood, WA 98036-5763

Mailing address

13502 106TH Dr SE
Snohomish, WA 98296-8245
Phone (360) 668-6908

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

LicenseStateTypeSpecialty
OT 00001530WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Return 2 Work, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608854400000",
    "number": "1952653768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13502 106TH DR SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982968245",
            "telephone_number": "360-668-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19231 36TH AVE W STE K",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365763",
            "telephone_number": "425-774-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2020-12-25",
        "certification_date": "2020-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 00001530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2020; 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.