Individual
JACQUELYN A MAHRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
MA00004643
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039584
LABOR AND INDUSTRIES #
WA
01
—
6443MA
BLUE SHIELD#
WA
01
—
US1051843
AETNA SPECIALIST PIN
WA
Enumeration date
01/18/2007
Last updated
07/08/2007
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