Provider Demographics
NPI:1841676186
Name:BULLERT, JOSEPH FREDERICK (OT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FREDERICK
Last Name:BULLERT
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18504 BOTHELL WAY NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:425-892-2243
Mailing Address - Fax:425-527-6948
Practice Address - Street 1:18606 BOTHELL WAY NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-892-2243
Practice Address - Fax:425-527-6948
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand