Healthcare Provider Details

I. General information

NPI: 1780854729
Provider Name (Legal Business Name): JANET L SHEFFERLY OTR/L INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BRISTOL CT SW # D-103
OLYMPIA WA
98502-6003
US

IV. Provider business mailing address

2401 BRISTOL CT SW # D-103
OLYMPIA WA
98502-6003
US

V. Phone/Fax

Practice location:
  • Phone: 360-786-9400
  • Fax: 360-786-9400
Mailing address:
  • Phone: 360-786-9400
  • Fax: 360-786-9400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT00000549
License Number StateWA

VIII. Authorized Official

Name: MS. JANET SHEFFERLY
Title or Position: OWNER
Credential: OTR/L
Phone: 360-786-9400