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NPI Code Detail

MEDICARE: NANNETTE MARIE KRUEGER OTR

MEDICARE: NANNETTE MARIE KRUEGER 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
1225XP0200XPediatric Occupational Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100002268OTHERWAOT LICENSE

General Provider Information

NPI Number : 1710014329
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANNETTE MARIE KRUEGER OTR
Provider Business Mailing Address
First Line : 1407 BOALCH AVE NW
Second Line :
City : NORTH BEND
State : WA
Zip : 98045-7994
Country : US
Telephone Number : 425-888-2777
Fax Number :
Provider Business Practice Location Address
First Line : 9050 384TH AVE SE
Second Line :
City : SNOQUALMIE
State : WA
Zip : 98065-9637
Country : US
Telephone Number : 425-888-3347
Fax Number : 425-888-3348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 03/25/2025

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Directions to “ NANNETTE MARIE KRUEGER OTR” Practice Location

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