Healthcare Provider Details

I. General information

NPI: 1730239633
Provider Name (Legal Business Name): SHELLY L. APPLETON O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 1ST AVE N STE 200
SEATTLE WA
98109-4744
US

IV. Provider business mailing address

415 1ST AVE N STE 200
SEATTLE WA
98109-4744
US

V. Phone/Fax

Practice location:
  • Phone: 206-859-5030
  • Fax: 206-859-5031
Mailing address:
  • Phone: 206-859-5030
  • Fax: 206-859-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT00002270
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: