Individual
CERISSA NINA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2202 144TH AVE SE, BELLEVUE, WA 98007-6220
(941) 661-4637
Mailing address
2202 144TH AVE SE, BELLEVUE, WA 98007-6220
(941) 661-4637
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT12295
FL
225X00000X
Occupational Therapist
Primary
OT61296396
WA
Other
Enumeration date
05/09/2007
Last updated
07/28/2023
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