Basic Information
Provider Information
NPI: 1376646182
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SMITH
FirstName: PAULA
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 24366
Address2: M/S 359107
City: SEATTLE
State: WA
PostalCode: 981240366
CountryCode: US
TelephoneNumber: 2065980502
FaxNumber: 2065980516
Practice Location
Address1: WASHINGTON HAND THERAPY-10564 5TH AVE NE #402
Address2:  
City: SEATTLE
State: WA
PostalCode: 98125
CountryCode: US
TelephoneNumber: 2064863337
FaxNumber: 2065021027
Other Information
ProviderEnumerationDate: 09/07/2006
LastUpdateDate: 03/30/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT00001913WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home