Healthcare Provider Details

I. General information

NPI: 1841564655
Provider Name (Legal Business Name): MARISA RUTH HUN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARISA RUTH PRIOR

II. Dates (important events)

Enumeration Date: 02/27/2012
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 MONTE VILLA PKWY
BOTHELL WA
98021-8972
US

IV. Provider business mailing address

16030 BOTHELL EVERETT HWY STE 140
MILL CREEK WA
98012-1273
US

V. Phone/Fax

Practice location:
  • Phone: 425-408-6000
  • Fax:
Mailing address:
  • Phone: 425-338-9005
  • Fax: 425-337-0931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60271381
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: