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General NPI Number Information
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NPI Number | 1730489717
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Entity Type | Individual
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Provider Name | CHRISTINE ANN SICURO-FOUTY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 6601 220TH ST SW SUITE 1
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2166
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Country | US
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Telephone | 425-775-7274
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Fax | 425-775-0963
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Provider Business Mailing Address
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Address Line | 1005 7TH AVE S
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City | EDMONDS
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State | WA
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Zip | 98020-4015
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Country | US
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Telephone | 425-776-3637
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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 | OT60178589
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License Number State | WA
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