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General NPI Number Information
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NPI Number | 1255516092
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Entity Type | Organization
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Legal Business Name | PACIFIC HANDWORKS INC., P.S.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 2800 NORTHUP WAY 200
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City | BELLEVUE
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State | WA
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Zip | 98004-1440
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Country | US
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Telephone | 425-827-5877
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Fax | 425-827-5843
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Provider Business Mailing Address
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Address Line | 2800 NORTHUP WAY 200
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City | BELLEVUE
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State | WA
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Zip | 98004-1440
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Country | US
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Telephone | 425-827-5877
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Fax | 425-827-5843
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Authorized Official
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Title or Position | OCCUPATIONAL HAND THERAPIST
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Name | MS. KALAIVANI MOODALY
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Credential | OTR/L
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Telephone | 425-827-5877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | OT00002234
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License Number State | WA
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