Healthcare Provider Details

I. General information

NPI: 1013849033
Provider Name (Legal Business Name): RANDY WOYCHUK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4746 11TH AVE NE STE 102
SEATTLE WA
98105-4660
US

IV. Provider business mailing address

4746 11TH AVE NE STE 102
SEATTLE WA
98105-4660
US

V. Phone/Fax

Practice location:
  • Phone: 206-257-7191
  • Fax:
Mailing address:
  • Phone: 206-257-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.OT.70005691
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: