Provider Demographics
NPI:1225687643
Name:SALES, ANNA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNA MARIE
Middle Name:
Last Name:SALES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 N 10TH PL APT 1319
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5466
Mailing Address - Country:US
Mailing Address - Phone:817-247-1023
Mailing Address - Fax:
Practice Address - Street 1:1495 NW GILMAN BLVD STE 4
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5328
Practice Address - Country:US
Practice Address - Phone:425-392-2346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117609225XP0019X
WA60961104225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117609OtherOT LICENSE
WA60961104OtherOT LICENSE