Provider Demographics
NPI:1780854729
Name:JANET L SHEFFERLY OTR/L INC.
Entity Type:Organization
Organization Name:JANET L SHEFFERLY OTR/L INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFERLY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:360-786-9400
Mailing Address - Street 1:2401 BRISTOL CT SW # D-103
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-6003
Mailing Address - Country:US
Mailing Address - Phone:360-786-9400
Mailing Address - Fax:360-786-9400
Practice Address - Street 1:2401 BRISTOL CT SW # D-103
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-6003
Practice Address - Country:US
Practice Address - Phone:360-786-9400
Practice Address - Fax:360-786-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000549225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7680051Medicaid
WASH2300OtherREGENCE BLUE SHIELD