Provider Demographics
NPI:1033581954
Name:PRICE, AMELIA (OT)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19689 7TH AVE NE # 109
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8091
Mailing Address - Country:US
Mailing Address - Phone:360-979-7970
Mailing Address - Fax:
Practice Address - Street 1:8145 NE BEACHWOOD AVE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7776
Practice Address - Country:US
Practice Address - Phone:360-979-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XN1300X
WAOT 00003844225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation