Provider Demographics
NPI:1558758045
Name:HAMILTON, ZACHARY (COTA/L)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 QUEEN ANNE AVE N APT 210
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2878
Mailing Address - Country:US
Mailing Address - Phone:253-709-4062
Mailing Address - Fax:
Practice Address - Street 1:2830 I ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-2410
Practice Address - Country:US
Practice Address - Phone:253-561-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60545471224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant