Provider Demographics
NPI:1689952194
Name:BELDING-WILSON, DAWN DANIELLE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:DANIELLE
Last Name:BELDING-WILSON
Suffix:
Gender:F
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 1:240 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SILVERLAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98645-9755
Mailing Address - Country:US
Mailing Address - Phone:208-899-6516
Mailing Address - Fax:
Practice Address - Street 1:1500 3RD AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3229
Practice Address - Country:US
Practice Address - Phone:360-423-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60230550225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist