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General NPI Number Information
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NPI Number | 1083894448
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Entity Type | Individual
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Provider Name | MICHELLE JEANNETTE NORDSTROM OT
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Gender | Female
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 8901 ROCKVILLE PIKE
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City | BETHESDA
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State | MD
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Zip | 20889-5647
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Country | US
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Telephone | 301-400-2253
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 JONES BRIDGE RD
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City | BETHESDA
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State | MD
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Zip | 20814-4712
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Country | US
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Telephone | 218-208-8360
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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 | 103471
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License Number State | MN
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