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NPI Code Detail

MEDICARE: EDITH SEYL POLSON OTR/L

MEDICARE: EDITH SEYL POLSON OTR/L
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
1225X00000XOccupational Therapist254979OR

General Provider Information

NPI Number : 1154659555
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDITH SEYL POLSON OTR/L
Provider Business Mailing Address
First Line : 2002 12TH ST
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-9543
Country : US
Telephone Number : 541-386-1211
Fax Number : 541-386-7211
Provider Business Practice Location Address
First Line : 2002 12TH ST
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-9543
Country : US
Telephone Number : 541-386-1211
Fax Number : 541-386-7211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2009
Last Update Date : 11/23/2009

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Directions to “ EDITH SEYL POLSON OTR/L” Practice Location

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