Individual
JITKA FIALA TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
21008 76TH AVE W, EDMONDS, WA 98026-7104
(425) 778-0107
Mailing address
14233 30TH AVE SE, MILL CREEK, WA 98012-5002
(425) 338-5902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001778
WA
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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