Healthcare Provider Details

I. General information

NPI: 1831545631
Provider Name (Legal Business Name): KAYLA LINDELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 N 85TH ST
SEATTLE WA
98103-3721
US

IV. Provider business mailing address

4220 132ND ST SE SUITE 101
MILL CREEK WA
98012-8999
US

V. Phone/Fax

Practice location:
  • Phone: 206-900-8883
  • Fax: 206-962-3792
Mailing address:
  • Phone: 425-316-8046
  • Fax: 425-338-9637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60642002
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: