Provider Demographics
NPI:1750496691
Name:SPAETH, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:SPAETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 CALIFORNIA AVE SW
Mailing Address - Street 2:APT 304
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2194
Mailing Address - Country:US
Mailing Address - Phone:206-770-3387
Mailing Address - Fax:
Practice Address - Street 1:12500 AURORA AVE N
Practice Address - Street 2:STE C
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-1518
Practice Address - Country:US
Practice Address - Phone:206-524-6916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT00003791OtherLICENSE #