Healthcare Provider Details
I. General information
NPI: 1245171131
Provider Name (Legal Business Name): WASHINGTON UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1631 A ROY DR
WASHINGTON MO
63090-5008
US
IV. Provider business mailing address
4320 FOREST PARK AVE STE 302
SAINT LOUIS MO
63108-2979
US
V. Phone/Fax
- Phone: 314-286-1669
- Fax: 314-627-7219
- Phone: 314-273-4125
- Fax: 314-627-7219
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
NELLIS
Title or Position: CLINICAL DIRECTOR
Credential: OTD, OTR/L, MBA
Phone: 314-286-2233