Provider Demographics
NPI:1346587250
Name:PRENDERGAST, JANET DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:DENISE
Last Name:PRENDERGAST
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 1:4922 146TH PL SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-8983
Mailing Address - Country:US
Mailing Address - Phone:425-316-3337
Mailing Address - Fax:
Practice Address - Street 1:4922 146TH PL SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-8983
Practice Address - Country:US
Practice Address - Phone:425-316-3337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00001571225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist