MEDICARE: SEATTLE THERAPY SERVICES

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	235Z00000X	Speech-Language Pathologist	SLPI. SI.60477449	WA

General Provider Information

NPI Number	:	1720480494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEATTLE THERAPY SERVICES

Provider Business Mailing Address
First Line	:	2517 EASTLAKE AVE E
Second Line	:	SUITE 102
City	:	SEATTLE
State	:	WA
Zip	:	98102-3278
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2517 EASTLAKE AVE E
Second Line	:	SUITE 102
City	:	SEATTLE
State	:	WA
Zip	:	98102-3278
Country	:	US
Telephone Number	:	206-322-5433
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SHELLEY O'DONNELL
Credential	:	MS, OTRL
Telephone Number	:	206-390-3712

Provider Enumeration Date	:	09/24/2014
Last Update Date	:	09/24/2014

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Directions to “SEATTLE THERAPY SERVICES ” Practice Location

Language	Start Address	Practice Location

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