Provider Demographics
NPI:1700923315
Name:VIVIANO, ANN K (MS MA OT SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:K
Last Name:VIVIANO
Suffix:
Gender:F
Credentials:MS MA OT SLP
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Mailing Address - Street 1:915 118TH AVE SE
Mailing Address - Street 2:STE 110
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3875
Mailing Address - Country:US
Mailing Address - Phone:425-450-9474
Mailing Address - Fax:425-452-0704
Practice Address - Street 1:402 15TH AVE SE
Practice Address - Street 2:#100
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3709
Practice Address - Country:US
Practice Address - Phone:253-697-5200
Practice Address - Fax:253-697-5145
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2019-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WALL00003579235Z00000X
WAOT00003809225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist