Provider Demographics
NPI:1942435938
Name:MCDONALD, MELISSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MCDONALD
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 1:32504 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-8726
Mailing Address - Country:US
Mailing Address - Phone:206-561-6862
Mailing Address - Fax:
Practice Address - Street 1:9050 384TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9637
Practice Address - Country:US
Practice Address - Phone:425-888-3347
Practice Address - Fax:425-888-3348
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60828743225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics