Active NPI
Stacy Beth Wien, COTA
- Occupational Therapy Assistant
- Bothell, WA
National Provider Identifier
1972152478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 407038
- Practice address
- 18504 Bothell Way NE
Bothell, WA 98011-1927 - Phone
- (425) 481-1933
- Fax
- (425) 527-6948
- NPI assigned
- Sep 6, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OC60865959 | WA | |
| Occupational Therapy Assistant | 224Z00000X | 407038 | AZ | Primary |
Addresses
Primary practice location
18504 Bothell Way NE
Bothell, WA 98011-1927
Mailing address
18504 Bothell Way NE
Bothell, WA 98011-1927
Phone (425) 481-1933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GAB35998 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | stacyw@bpht.com | Direct | Bothell Pediatric & Hand Therapy |
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 |
|---|---|---|---|
| 407038 | AZ | MD | Occupational Therapy Assistant |
| OC60865959 | WA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1972152478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18504 BOTHELL WAY NE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980111927",
"telephone_number": "425-481-1933",
"fax_number": "425-527-6948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18504 BOTHELL WAY NE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980111927",
"telephone_number": "425-481-1933",
"fax_number": "425-527-6948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEN",
"first_name": "STACY",
"middle_name": "BETH",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-06",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WA",
"license": "OC60865959",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "407038",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GAB35998",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "stacyw@bpht.com",
"affiliation": "Y",
"affiliationName": "Bothell Pediatric & Hand Therapy",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "18504 - Bothell Way NE",
"city": "Bothell",
"state": "WA",
"country_code": "US",
"postal_code": "98011",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.