Provider Demographics
NPI:1629105556
Name:WASHWELL, NANCY M (OTR)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:WASHWELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 MERRILL ST APT 413
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4014
Mailing Address - Country:US
Mailing Address - Phone:805-821-1585
Mailing Address - Fax:
Practice Address - Street 1:140 HERMAN AVE
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2920
Practice Address - Country:US
Practice Address - Phone:805-821-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7721225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist