Provider Demographics
NPI:1790036242
Name:MOUNT, DOROTHY FENDLEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:FENDLEY
Last Name:MOUNT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:D.
Other - Middle Name:FENDLEY
Other - Last Name:MOUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:402 BOULEVARD
Mailing Address - Street 2:UNIT 301
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5361
Mailing Address - Country:US
Mailing Address - Phone:360-988-4121
Mailing Address - Fax:
Practice Address - Street 1:402 BOULEVARD
Practice Address - Street 2:UNIT 301
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5361
Practice Address - Country:US
Practice Address - Phone:360-988-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001827225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist