Provider Demographics
NPI:1184148413
Name:HEAL, JOHN JULIAN (COTA/L)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JULIAN
Last Name:HEAL
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 LEARY AVE NW UNIT 321
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4074
Mailing Address - Country:US
Mailing Address - Phone:215-584-5022
Mailing Address - Fax:
Practice Address - Street 1:5440 LEARY AVE NW
Practice Address - Street 2:UNIT 321
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107
Practice Address - Country:US
Practice Address - Phone:215-584-5022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60757494224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant