Provider Demographics
NPI:1801075171
Name:MARCELLO, CARRIE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:MARCELLO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10855 SILVERDALE WAY NW UNIT 3175
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7510
Mailing Address - Country:US
Mailing Address - Phone:360-621-3341
Mailing Address - Fax:
Practice Address - Street 1:10855 SILVERDALE WAY NW UNIT 3175
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7510
Practice Address - Country:US
Practice Address - Phone:360-621-3341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist