Provider Demographics
NPI:1326070780
Name:KELLER, JOANN L (OT)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:L
Last Name:KELLER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:K
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:19203 36TH AVE W STE 103
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5772
Mailing Address - Country:US
Mailing Address - Phone:425-368-7943
Mailing Address - Fax:425-368-5236
Practice Address - Street 1:19203 36TH AVE W STE 103
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5772
Practice Address - Country:US
Practice Address - Phone:425-368-7943
Practice Address - Fax:425-368-7443
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist