Healthcare Provider Details

I. General information

NPI: 1912457631
Provider Name (Legal Business Name): MARGERY J. HENNING MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11053 12TH AVE SW
SEATTLE WA
98146-2127
US

IV. Provider business mailing address

11053 12TH AVE SW
SEATTLE WA
98146-2127
US

V. Phone/Fax

Practice location:
  • Phone: 716-316-9894
  • Fax: 716-688-9132
Mailing address:
  • Phone: 716-316-9894
  • Fax: 716-688-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 60650688
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberOT 60650688
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225XH1300X
TaxonomyHuman Factors Occupational Therapist
License NumberOT 60650688
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License NumberOT 60650688
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 60650688
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: