Individual
MRS. MICHELLE LYN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
386 TUTTLE LN, BURBANK, WA 99323-9717
(509) 302-1459
Mailing address
386 TUTTLE LN, BURBANK, WA 99323-9717
(509) 302-1459
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
00001513
WA
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001513
—
WA
Enumeration date
11/15/2012
Last updated
02/26/2020
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