Individual
DONNA MARDELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
17518 NE 134TH PL, REDMOND, WA 98052-2106
(425) 881-1342
Mailing address
17518 NE 134TH PL, REDMOND, WA 98052-2106
(425) 881-1342
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60355569
WA
Other
Enumeration date
09/14/2013
Last updated
09/14/2013
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