Provider Demographics
NPI:1154667327
Name:JARCHOW, MICHIKO GRACE (MS/OT/L)
Entity Type:Individual
Prefix:
First Name:MICHIKO
Middle Name:GRACE
Last Name:JARCHOW
Suffix:
Gender:F
Credentials:MS/OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6729 141ST ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8961
Mailing Address - Country:US
Mailing Address - Phone:425-337-2079
Mailing Address - Fax:
Practice Address - Street 1:4730 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2927
Practice Address - Country:US
Practice Address - Phone:425-385-5259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00000757225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist