Provider Demographics
NPI:1336443589
Name:JUNKER, INGRID (BSC, OT)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:JUNKER
Suffix:
Gender:F
Credentials:BSC, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22310 95TH PL W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-4521
Mailing Address - Country:US
Mailing Address - Phone:425-775-4798
Mailing Address - Fax:
Practice Address - Street 1:19231 36TH AVE W
Practice Address - Street 2:SUITE K
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5763
Practice Address - Country:US
Practice Address - Phone:425-774-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003330225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist