MIRANDA J GORDON (NPI# 1275793671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275793671 |
| Entity Type | Individual |
| Full Name | MIRANDA J GORDON |
| Credential | OTR L |
| Practice Address |
800 West Maple Street Medical Lake WA 99022-0800 |
| Practice Telephone | 5092993121 |
| Practice Fax Number | 5092997015 |
| Mailing Telephone | 5092993121 |
| Mailing Fax Number | 5092997015 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT00003212 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
800 WEST MAPLE STREET |
| City | MEDICAL LAKE |
| State | WA |
| Zip Code | 99022-0800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437149440 | Imelda D. Goyanko-borrowmeo | Psychiatry & Neurology | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-10-21 |
| 1316299381 | Sabrina Arnott Keckalo | Physician Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2012-10-15 |
| 1912223454 | Robert Cory Fanto | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2010-04-08 |
| 1184955874 | Sandra D Phillips | Dental Hygienist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2010-01-20 |
| 1508013764 | Nosrat Aflatooni | Physician Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2008-08-19 |
| 1043488570 | Michelle D Wellman | Occupational Therapy Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2008-02-19 |
| 1689749277 | Timothy J Pinnell | Occupational Therapy Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-21 |
| 1225107287 | Janice L Williams | Dental Hygienist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-06 |
| 1881763928 | Marcia L Ryan | Speech-Language Pathologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-06 |
| 1679651970 | Eastern State Hospital Pharmacy | Psychiatric Hospital | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417462227 | Alicia Burton Dds Pllc | Clinic/Center | 47 E. Wa 902, Medical Lake, WA 99022 | 2017-12-04 |
| 1487100038 | Tammy Lee Adler | Pharmacist | 1010 W Fir St, Medical Lake, WA 99022 | 2016-09-01 |
| 1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
| 1033546288 | Torrance Whitney Baldwin | Speech-Language Pathologist | 116 West 3rd St., Medical Lake, WA 99022 | 2013-10-02 |
| 1144572710 | Keri Lea Wissink | Speech-Language Pathologist | 116 West Thrird Street, Medical Lake, WA 99022 | 2012-10-08 |
| 1609153766 | Dutton Veterinary Medicine Pllc | Special Hospital | 212 East Lake Street, Medical Lake, WA 99022 | 2011-11-03 |
| 1881912962 | Susan L Vanwormer | Counselor | 108 N. Jefferson, Medical Lake, WA 99022 | 2010-05-13 |
| 1467774232 | Ryan K Love | Dentist | N 123 Brower Street, Medical Lake, WA 99022 | 2010-02-22 |
| 1023263464 | Emily S Mildes | Nurse Practitioner | 1451 W Maple, Medical Lake, WA 99022 | 2008-11-26 |
| 1619005014 | Maria Lydia Montenegro | General Practice | 2320 Salnave Rd, Lakeland Village, Medical Lake, WA 99022 | 2007-02-28 |
| Find all providers in zip 99022 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528144524 | Carey Blackmon | Occupational Therapist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-10-31 |
| 1235215237 | Terry Glenn | Occupational Therapist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-10-31 |
| 1962588962 | Mary Kay Miller | Occupational Therapist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-10-31 |
| 1134205131 | Connie Nelson | Occupational Therapist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345401 | Nancy Johnson Speech & Language Ps | Occupational Therapist | 9802 48th Dr Ne, Marysville, WA 98270-8100 | 2020-10-28 |
| 1871193193 | Sarah V Swan | Occupational Therapist | 12033 Se 265th St, Kent, WA 98030 | 2020-10-27 |
| 1104425966 | Kristy Claire Braunston | Occupational Therapist | 19640 Se 272nd St, Covington, WA 98042-8553 | 2020-10-22 |
| 1679172423 | Jasmine Anastasia Pielemeier | Occupational Therapist | 1724 13th Ave S Apt B, Seattle, WA 98144-4173 | 2020-10-22 |
| 1811594252 | Leaps and Bounds Pediatric Therapy | Occupational Therapist | 3231 Willamette Dr Ne Ste A, Lacey, WA 98516-1378 | 2020-10-08 |
| 1972100840 | Lindsay Anne Reich | Occupational Therapist | 5962 Nw 38th Ave Unit 531, Camas, WA 98607-5408 | 2020-10-05 |
| 1144837477 | Feby Bianca Caoile | Occupational Therapist | 430 210th St Se, Bothell, WA 98021-7648 | 2020-09-30 |
| 1093321069 | Hannah Joy Terranova | Occupational Therapist | 9951 Mickelberry Rd Nw Ste 123, Silverdale, WA 98383-8309 | 2020-09-16 |
| 1114533148 | Jennifer Marie Wong | Occupational Therapist | 6819 Vista Ave S, Seattle, WA 98108-3651 | 2020-09-15 |
| 1982219416 | Ascend Therapy Services Pllc | Occupational Therapist | 20045 Se 267th Pl, Covington, WA 98042-6151 | 2020-09-11 |
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| City | MEDICAL LAKE |
| Zip Code | 99022 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.