Healthcare Provider Details

I. General information

NPI: 1760581508
Provider Name (Legal Business Name): HIROKO MCMILLIAN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 AURORA AVE N SUITE 100
SEATTLE WA
98103
US

IV. Provider business mailing address

4300 AURORA AVE N SUITE 100
SEATTLE WA
98103
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 NumberAA555458
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: