MEDICARE: LORI STEPHENS OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT00000917	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205038460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI STEPHENS OT

Provider Business Mailing Address
First Line	:	400 S 43RD ST
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98055-5714
Country	:	US
Telephone Number	:	425-251-5165
Fax Number	:	425-656-4028

Provider Business Practice Location Address
First Line	:	3600 LIND AVE SW STE 170
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-4934
Country	:	US
Telephone Number	:	425-690-3555
Fax Number	:	425-690-9555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	05/25/2021

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Directions to “ LORI STEPHENS OT” Practice Location

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