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Organization

BALANCE OT, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY A CLANCY OTR/L, CHT (OWNER)
(206) 508-1265
Entity
Organization

Contact information

Practice address
2821 NW MARKET ST STE E, SEATTLE, WA 98107-5815
(206) 508-1265
(206) 508-1265
Mailing address
3323 NW 71ST ST, SEATTLE, WA 98117-6146
(206) 508-1265
(206) 508-1265

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OT00001887
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0207147
LABOR AND INDUSTRIES-WA
WA
01
4020-CL
REGENCE
WA
Enumeration date
04/08/2008
Last updated
07/13/2009
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