Individual
MELINDA BORTOLAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1010 SOUTH 336TH STREET, SUITE 210, FEDERAL WAY, WA 98003
(425) 308-8119
Mailing address
1010 SOUTH 336TH STREET, SUITE 210, FEDERAL WAY, WA 98003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60166229
WA
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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