Organization
PEDIATRIC NDT & SI THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN A MCNUTT OTR (OCCUPATIONAL THERAPIST)
(360) 398-2772
Entity
Organization
Contact information
Practice address
348 W KING TUT RD, BELLINGHAM, WA 98226-9652
(360) 398-2772
(360) 398-2772
Mailing address
348 W KING TUT RD, BELLINGHAM, WA 98226-9652
(360) 398-2772
(360) 398-2772
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
WA
225XP0200X
Pediatric Occupational Therapist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7680911
—
WA
Enumeration date
01/23/2007
Last updated
06/14/2024
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