Active NPI
Vanda Marion Russell
- Occupational Therapist
- Lynden, WA
National Provider Identifier
1972879898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 908
- Practice address
- 855 Aaron Dr
Lynden, WA 98264-9396 - Phone
- (360) 354-4434
- NPI assigned
- Mar 25, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 908 | WA | Primary |
Addresses
Primary practice location
855 Aaron Dr
Lynden, WA 98264-9396
Mailing address
5056 Festival Blvd Apt a
Bellingham, WA 98226-7610
Phone (360) 734-7177
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 |
|---|---|---|---|
| 908 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332633600000",
"number": "1972879898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5056 FESTIVAL BLVD APT A",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982267610",
"telephone_number": "360-734-7177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 AARON DR",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982649396",
"telephone_number": "360-354-4434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "VANDA",
"middle_name": "MARION",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-25",
"last_updated": "2012-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynden, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.