Provider Demographics
NPI:1083274666
Name:WASHINGTON, ENJOLI (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ENJOLI
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33330 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6325
Mailing Address - Country:US
Mailing Address - Phone:253-945-2086
Mailing Address - Fax:253-945-2177
Practice Address - Street 1:4014 S 270TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7139
Practice Address - Country:US
Practice Address - Phone:253-945-4015
Practice Address - Fax:253-945-2177
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60850299225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist