Andrea Freeborn, MSOT, OTR/L

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

OT60068984 Issued in WA

Practice address

3901 Capital Mall Dr SW
Olympia, WA 98502-8654

Phone

(360) 786-8990

NPI assigned

Oct 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freeborn Wellness PLLCGroup PAC ID 9032520473, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Freeborn Wellness, PLLC

  • Occupational Therapist
  • Lacey, WA
  • NPI 1518324649
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1982007035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 HARRISON AVE",
            "address_2": "STE A",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311300",
            "telephone_number": "360-870-2473",
            "fax_number": "360-312-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CAPITAL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-786-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEBORN",
        "first_name": "ANDREA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60068984",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "OT60068984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Terry Frazee, DPT
• Theodore Alan Frazier Sr., CAAR
• Fred Griesman MD
• Jennifer Mae Frederick
• Mary E Fredericks, ARNP
• Rebecca Freeman, M.D.
• Jeremy William Freier
• Collins Kenneth Freitas, C.PED.
• Jean Constance Frey, LM
• Rachel Frickleton

• Community Health Worker in Olympia, WA
• Providers in Olympia, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.