Healthcare Provider Details

I. General information

NPI: 1184537029
Provider Name (Legal Business Name): WASHINGTON UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 S GEYER RD STE 130
SAINT LOUIS MO
63127-1234
US

IV. Provider business mailing address

4320 FOREST PARK AVE STE 302
SAINT LOUIS MO
63108-2979
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-1669
  • Fax: 314-627-7219
Mailing address:
  • Phone: 314-273-4125
  • Fax: 314-627-7219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA NELLIS
Title or Position: CLINICAL DIRECTOR
Credential: OTD,OTR/L,FNAP
Phone: 314-286-2233