Individual
ANDREA STATHOULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
20310 19TH AVE NE, SHORELINE, WA 98155-1261
(206) 367-5853
Mailing address
22814 75TH AVE W, EDMONDS, WA 98026-8514
(425) 775-3190
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT00003886
WA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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