Provider Demographics
NPI:1295851210
Name:FUHR, MARY GENGLER (OTRL)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:GENGLER
Last Name:FUHR
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16122 SE 266TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-8218
Mailing Address - Country:US
Mailing Address - Phone:206-612-6201
Mailing Address - Fax:
Practice Address - Street 1:22443 SE 240TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5898
Practice Address - Country:US
Practice Address - Phone:425-358-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000646225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist