Provider Demographics
NPI:1578816161
Name:O'GRADY, DARLENE SUE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:SUE
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:DARLENE
Other - Middle Name:SUE
Other - Last Name:MACLEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:200 E FREMONT ST
Mailing Address - Street 2:TRUE
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2336
Mailing Address - Country:US
Mailing Address - Phone:360-804-3530
Mailing Address - Fax:360-804-2529
Practice Address - Street 1:200 E FREMONT ST
Practice Address - Street 2:TRUE
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2336
Practice Address - Country:US
Practice Address - Phone:360-804-3530
Practice Address - Fax:360-804-2529
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00000243225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist