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NPI Code Detail

MEDICARE: BALANCE OT, INC

MEDICARE: BALANCE OT, INC
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
1261QR0400XRehabilitation Clinic/CenterOT00001887WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14020-CLOTHERWAREGENCE
20207147OTHERWALABOR AND INDUSTRIES-WA

General Provider Information

NPI Number : 1770756090
Entity Type Code : Organization
Provider Name (Legal Business Name) : BALANCE OT, INC
Provider Business Mailing Address
First Line : 3323 NW 71ST ST
Second Line :
City : SEATTLE
State : WA
Zip : 98117-6146
Country : US
Telephone Number : 206-508-1265
Fax Number : 206-508-1265
Provider Business Practice Location Address
First Line : 2821 NW MARKET ST STE E
Second Line :
City : SEATTLE
State : WA
Zip : 98107-5815
Country : US
Telephone Number : 206-508-1265
Fax Number : 206-508-1265
Authorized Official
Title or Position : OWNER
Name : KELLY A CLANCY
Credential : OTR/L, CHT
Telephone Number : 206-508-1265
Provider Enumeration Date : 04/08/2008
Last Update Date : 07/13/2009

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Directions to “BALANCE OT, INC ” Practice Location

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