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NPI Code Detail

MEDICARE: MS. ALISON FILLMORE MS, OTR/L

MEDICARE:  MS. ALISON  FILLMORE  MS, OTR/L
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
1225XP0200XPediatric Occupational TherapistOT60248754WA

General Provider Information

NPI Number : 1699010546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALISON FILLMORE MS, OTR/L
Provider Business Mailing Address
First Line : 215 N J ST
Second Line :
City : TACOMA
State : WA
Zip : 98403-1927
Country : US
Telephone Number : 253-576-2817
Fax Number :
Provider Business Practice Location Address
First Line : 2689 HOOVER AVE SE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-3013
Country : US
Telephone Number : 360-443-3535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2012
Last Update Date : 12/04/2012

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