MEDICARE: MS. ANNASTASSIA MINA WOO NELSON M.S., OT-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT60538960	WA

General Provider Information

NPI Number	:	1043603962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNASTASSIA MINA WOO NELSON M.S., OT-R

Provider Business Mailing Address
First Line	:	5238 57TH AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2517
Country	:	US
Telephone Number	:	206-618-5632
Fax Number	:

Provider Business Practice Location Address
First Line	:	5238 57TH AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2517
Country	:	US
Telephone Number	:	206-618-5632
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2015
Last Update Date	:	11/29/2025

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