Provider Demographics
NPI:1508529447
Name:CHAUDHARY, TALAL (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:TALAL
Middle Name:
Last Name:CHAUDHARY
Suffix:
Gender:M
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 177TH PL SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-3930
Mailing Address - Country:US
Mailing Address - Phone:206-599-9401
Mailing Address - Fax:
Practice Address - Street 1:14905 BOTHELL EVERETT HWY
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-5315
Practice Address - Country:US
Practice Address - Phone:844-411-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014535225X00000X
WAOT61309942225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist