Provider Demographics
NPI:1831207620
Name:MCMILLAN, SUSAN LYNN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNN
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-768-5270
Mailing Address - Fax:206-764-2799
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:MS-128SCI
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-768-5270
Practice Address - Fax:206-764-2799
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000172225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist