Healthcare Provider Details

I. General information

NPI: 1831243658
Provider Name (Legal Business Name): RACHEL N MORITZ MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 S I ST STE 202B
TACOMA WA
98405-5092
US

IV. Provider business mailing address

1909 2ND AVE W
BREMERTON WA
98312-4740
US

V. Phone/Fax

Practice location:
  • Phone: 253-527-5550
  • Fax:
Mailing address:
  • Phone: 262-812-6321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3802-26
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License NumberOT60933255
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT60933255
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60933255
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: