Provider Demographics
NPI:1619044187
Name:RAST, MECHTHILD MARTHA (PHD)
Entity Type:Individual
Prefix:MS
First Name:MECHTHILD
Middle Name:MARTHA
Last Name:RAST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 NE 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2005
Mailing Address - Country:US
Mailing Address - Phone:206-525-2272
Mailing Address - Fax:206-525-2272
Practice Address - Street 1:5731 NE 57TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2005
Practice Address - Country:US
Practice Address - Phone:206-525-2272
Practice Address - Fax:206-525-2272
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist