Provider Demographics
NPI:1316372394
Name:DALZIEL, JENNIFER C (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:DALZIEL
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:C
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:1401 S LAVENTURE RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-6033
Practice Address - Country:US
Practice Address - Phone:360-424-2400
Practice Address - Fax:360-424-2418
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60272846225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand