Individual
MRS. SHELLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
18504 BOTHELL WAY NE, BOTHELL, WA 98011-1927
(425) 481-1933
(425) 481-9371
Mailing address
18504 BOTHELL WAY NE, BOTHELL, WA 98011-1927
(425) 481-1933
(425) 481-9371
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC 60597494
WA
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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