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NPI Code Detail

MEDICARE: MRS. MOLLY VIRGINIA READ O.T.

MEDICARE: MRS. MOLLY VIRGINIA READ O.T.
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
1225X00000XOccupational Therapist511HI
2225X00000XOccupational Therapist60187420WA

General Provider Information

NPI Number : 1790998763
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MOLLY VIRGINIA READ O.T.
Provider Business Mailing Address
First Line : 365 BLACKSTONE CT
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-3636
Country : US
Telephone Number : 808-780-6394
Fax Number :
Provider Business Practice Location Address
First Line : 2031 POTTERY AVE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-2010
Country : US
Telephone Number : 360-876-8035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 06/09/2011

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