Healthcare Provider Details

I. General information

NPI: 1316378763
Provider Name (Legal Business Name): WELLNESS OCCUPATIONAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 N 45TH ST
SEATTLE WA
98103-6903
US

IV. Provider business mailing address

2205 N 45TH ST
SEATTLE WA
98103-6903
US

V. Phone/Fax

Practice location:
  • Phone: 206-604-4707
  • Fax: 206-367-9203
Mailing address:
  • Phone: 206-604-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MOLLY GOODMAN ALLISON
Title or Position: OWNER
Credential: OT
Phone: 206-604-4707