Individual
NITA FULWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA L/R
Contact information
Practice address
80 SW 2ND ST, RENTON, WA 98057-5937
(425) 226-4610
Mailing address
80 SW 2ND ST, RENTON, WA 98057-5937
(425) 226-4610
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
03/21/2009
Last updated
03/21/2009
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