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General NPI Number Information
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NPI Number | 1285970566
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Entity Type | Individual
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Provider Name | ELICIA MAUREEN CARTMELL DEMERRITT MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 1601 AVENUE D SNOHOMISH SCHOOL DISTRICT
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City | SNOHOMISH
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State | WA
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Zip | 98290-1799
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Country | US
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Telephone | 360-563-7308
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Fax |
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Provider Business Mailing Address
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Address Line | 20922 64TH ST SE
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City | SNOHOMISH
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State | WA
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Zip | 98290-6043
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Country | US
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Telephone | 509-430-5772
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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 | OT 00004518
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT 00004518
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 45528OH
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License Number State | WA
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