Provider Demographics
NPI:1356522346
Name:ROSEVEAR, JUDITH ANN (MS,OTR/L)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:ROSEVEAR
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:MRS
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:ROSEVEAR-PUSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS,OTR/L
Mailing Address - Street 1:15650 NE 24TH ST STE C3
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2460
Mailing Address - Country:US
Mailing Address - Phone:208-251-1747
Mailing Address - Fax:425-947-9841
Practice Address - Street 1:15650 NE 24TH ST STE C3
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008
Practice Address - Country:US
Practice Address - Phone:208-251-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-18
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT553225X00000X
OR067850225X00000X
IN31001125A225X00000X
WAOT 60067862225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2064337Medicaid