Provider Demographics
NPI:1205811478
Name:MCMURDIE, JESSICA E (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:E
Last Name:MCMURDIE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:CHINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1616 MONROE AVE NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3370
Mailing Address - Country:US
Mailing Address - Phone:425-443-4831
Mailing Address - Fax:425-793-0484
Practice Address - Street 1:1616 MONROE AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3370
Practice Address - Country:US
Practice Address - Phone:425-443-4831
Practice Address - Fax:425-793-0484
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003453225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics