Provider Demographics
NPI:1497258792
Name:JAMIE HUIZINGA PLLC
Entity Type:Organization
Organization Name:JAMIE HUIZINGA PLLC
Other - Org Name:JAMIE HUIZINGA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUIZINGA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:607-725-5084
Mailing Address - Street 1:505 BROADWAY E # 398
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5023
Mailing Address - Country:US
Mailing Address - Phone:607-725-5084
Mailing Address - Fax:
Practice Address - Street 1:6965 CALIFORNIA AVE SW # 398
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1953
Practice Address - Country:US
Practice Address - Phone:425-677-0276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT600023105225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty