MEDICARE: NANCY M. WASHWELL OTR

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	7721	CA

General Provider Information

NPI Number	:	1629105556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY M. WASHWELL OTR

Provider Business Mailing Address
First Line	:	1630 MERRILL ST APT 413
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-4014
Country	:	US
Telephone Number	:	805-821-1585
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 HERMAN AVE
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-2920
Country	:	US
Telephone Number	:	805-821-1585
Fax Number	:

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	04/23/2024

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