Provider Demographics
NPI:1700967387
Name:KING, SHEILA R (CHT-OTR/L)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:R
Last Name:KING
Suffix:
Gender:F
Credentials:CHT-OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 LAKE OTIS PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-563-8318
Mailing Address - Fax:907-563-3472
Practice Address - Street 1:4015 LAKE OTIS PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-563-8318
Practice Address - Fax:907-563-3472
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-007248225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK11919Medicare ID - Type Unspecified