Healthcare Provider Details

I. General information

NPI: 1578435913
Provider Name (Legal Business Name): LINNAEA WELD OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LENNY WELD

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NW MYHRE RD STE 101
SILVERDALE WA
98383-7672
US

IV. Provider business mailing address

PO BOX 400
INDIANOLA WA
98342-0400
US

V. Phone/Fax

Practice location:
  • Phone: 360-613-1834
  • Fax:
Mailing address:
  • Phone: 510-853-2610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT61684598
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: