Provider Demographics
NPI:1437933454
Name:DAVIDSON, JILL MARIE (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 62ND PL W
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4634
Mailing Address - Country:US
Mailing Address - Phone:425-501-6735
Mailing Address - Fax:
Practice Address - Street 1:12121 HARBOUR REACH DR STE 100
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5314
Practice Address - Country:US
Practice Address - Phone:360-525-1710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand