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NPI Code Detail

MEDICARE: MOLLY GOODMAN ALLISON OT

MEDICARE: MOLLY GOODMAN ALLISON 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
1225X00000XOccupational TherapistOT00001699WA

General Provider Information

NPI Number : 1255479382
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY GOODMAN ALLISON OT
Provider Business Mailing Address
First Line : 1815 N 43RD ST
Second Line :
City : SEATTLE
State : WA
Zip : 98103-7526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19930 BALLINGER WAY NE
Second Line :
City : SHORELINE
State : WA
Zip : 98155-1223
Country : US
Telephone Number : 206-417-6947
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2007
Last Update Date : 07/08/2007

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