Provider Demographics
NPI:1265756829
Name:VALENZUELA, JAMIE KRISTEN (OTD, MOTR/L)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:KRISTEN
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:OTD, MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:12806 20TH ST NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-9243
Mailing Address - Country:US
Mailing Address - Phone:425-335-1525
Mailing Address - Fax:425-397-0536
Practice Address - Street 1:12806 20TH ST NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-9243
Practice Address - Country:US
Practice Address - Phone:425-335-1525
Practice Address - Fax:425-397-0536
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003424225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist