Provider Demographics
NPI:1336159292
Name:LATHROP, INGRID D (OT)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:D
Last Name:LATHROP
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:INGRID
Other - Middle Name:D
Other - Last Name:HJELTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1306
Mailing Address - Country:US
Mailing Address - Phone:206-386-2142
Mailing Address - Fax:206-386-2999
Practice Address - Street 1:1101 MADISON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1306
Practice Address - Country:US
Practice Address - Phone:206-386-2142
Practice Address - Fax:206-386-2999
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000449225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA23776UOtherREGENCE BLUE SHIELD PIN