Provider Demographics
NPI:1326400227
Name:MCCARTHY, ERIN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14227 56TH AVE S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4508
Mailing Address - Country:US
Mailing Address - Phone:323-252-2984
Mailing Address - Fax:
Practice Address - Street 1:14227 56TH AVE S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4508
Practice Address - Country:US
Practice Address - Phone:323-252-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16806225X00000X
TX116857225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA337222OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
TX116857OtherTEXAS STATE LICENSURE