MEDICARE: MIRIAM MOSBACHER MOT, 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
1	225X00000X	Occupational Therapist	OT61171024	WA

General Provider Information

NPI Number	:	1275324071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM MOSBACHER MOT, OTR/L

Provider Business Mailing Address
First Line	:	6219 23RD AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-7022
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	723 N 78TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4730
Country	:	US
Telephone Number	:	773-331-6270
Fax Number	:

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

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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