Provider Demographics
NPI:1831302330
Name:MEYERS, AMY MARIE (OTR L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20302 24TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1325
Mailing Address - Country:US
Mailing Address - Phone:206-200-1346
Mailing Address - Fax:
Practice Address - Street 1:6912 220TH ST SW
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2169
Practice Address - Country:US
Practice Address - Phone:425-672-2716
Practice Address - Fax:425-672-2720
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003681225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics