=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295650547
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | IRIS SIOBHAN DONOHUE NOSEK OTD, OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2026
-----------------------------------------------------
Last Update Date | 08/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22978 SEATTER RD
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-209-3174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12117 DAPHNE LN NW APT H208
-----------------------------------------------------
City | SILVERDALE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98383-8603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number | OT.OT.70148189
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------