Healthcare Provider Details

I. General information

NPI: 1225943004
Provider Name (Legal Business Name): ASTRID ANTONIA GIBLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 43RD AVE E
SEATTLE WA
98112-6210
US

IV. Provider business mailing address

4560 SE INTERNATIONAL WAY STE 100
PORTLAND OR
97222-4628
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-0770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.OT.70143340
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: