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General NPI Number Information
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NPI Number | 1306667852
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Entity Type | Individual
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Provider Name | MERIDETH MICHELLE MACRAE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 2689 HOOVER AVE SE
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3013
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Country | US
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Telephone | 360-443-3633
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Fax |
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Provider Business Mailing Address
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Address Line | 11449 BRISTOL PL
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City | GIG HARBOR
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State | WA
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Zip | 98332-9791
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Country | US
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Telephone | 425-503-8722
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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 |
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License Number State |
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