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General NPI Number Information
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NPI Number | 1851943005
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Entity Type | Individual
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Provider Name | SAMUEL WELLS
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Gender | Male
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 33330 8TH AVE S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6325
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Country | US
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Telephone | 253-945-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 622 STRINGTOWN RD
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City | PARIS
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State | KY
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Zip | 40361-9387
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Country | US
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Telephone | 859-707-0562
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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 | 260033
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License Number State | KY
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