Healthcare Provider Details

I. General information

NPI: 1831723121
Provider Name (Legal Business Name): GEORGE HOTCHKIN OTD, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 NW JUNIPER ST STE 100
ISSAQUAH WA
98027-2717
US

IV. Provider business mailing address

654 MADISON AVE N
BAINBRIDGE ISLAND WA
98110-2719
US

V. Phone/Fax

Practice location:
  • Phone: 425-369-4702
  • Fax:
Mailing address:
  • Phone: 907-980-9835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number60995386
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: