Provider Demographics
NPI:1952750796
Name:SHAMOUILIAN, ARIEL
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:SHAMOUILIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14715 BEL RED RD
Mailing Address - Street 2:BUILDING G, SUITE 104
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3940
Mailing Address - Country:US
Mailing Address - Phone:425-503-9440
Mailing Address - Fax:
Practice Address - Street 1:14715 BEL RED RD
Practice Address - Street 2:BUILDING G, SUITE 104
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3940
Practice Address - Country:US
Practice Address - Phone:425-503-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-11
Last Update Date:2016-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60654031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist