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General NPI Number Information
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NPI Number | 1164985727
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Entity Type | Individual
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Provider Name | JOANN M DELVECCHIO OTR
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Gender | Female
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 400 29TH ST NE
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City | PUYALLUP
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State | WA
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Zip | 98372-6774
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Country | US
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Telephone | 253-307-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 7606 37TH ST W APT I
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-3203
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | OT60690145
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License Number State | WA
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