Individual
LISA K MANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9617 7TH AVE SE, EVERETT, WA 98208-3710
(425) 513-8509
Mailing address
10701 NE 42ND PL, KIRKLAND, WA 98033-7907
(425) 269-5056
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
60489252
WA
Other
Enumeration date
05/22/2015
Last updated
05/22/2015
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