Provider Demographics
NPI:1962659490
Name:DEFREITAS, SARAH JEAN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:DEFREITAS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 17TH AVE NW
Mailing Address - Street 2:#405
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3865
Mailing Address - Country:US
Mailing Address - Phone:860-930-8058
Mailing Address - Fax:
Practice Address - Street 1:5821 188TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4304
Practice Address - Country:US
Practice Address - Phone:425-563-6074
Practice Address - Fax:425-776-3230
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60036175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist