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General NPI Number Information
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NPI Number | 1710853106
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Entity Type | Individual
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Provider Name | LORENZO DIAZ CARRILLO OTD, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 19221 36TH AVE W STE 213
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City | LYNNWOOD
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State | WA
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Zip | 98036-5700
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Country | US
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Telephone | 425-368-7943
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 SW 170TH AVE APT 1516
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City | BEAVERTON
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State | OR
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Zip | 97003-8610
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Country | US
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Telephone | 541-740-6204
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OT70049130
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License Number State | WA
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