Individual
TERRY ANN MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6601 220TH ST SW, SUITE 1, MOUNTLAKE TERRACE, WA 98043-2166
(425) 775-7274
(425) 775-0963
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001899
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0302899
DEPT. OF LABOR AND INDUSTRIES
WA
05
—
1013110709
—
WA
01
—
139516
LNI
WA
Enumeration date
06/08/2007
Last updated
07/14/2015
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