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General NPI Number Information
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NPI Number | 1013409101
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Entity Type | Individual
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Provider Name | CULLYN FOXLEE
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Gender | Female
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 8011 112TH STREET CT E
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City | PUYALLUP
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State | WA
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Zip | 98373-7814
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Country | US
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Telephone | 253-848-0662
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Fax |
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Provider Business Mailing Address
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Address Line | 6050 TACOMA MALL BLVD STE 120
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City | TACOMA
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State | WA
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Zip | 98409-6811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 60856718
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License Number State | WA
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