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Individual

MS. KELLIE ANN HISLOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L, CHT

Contact information

Practice address
510 8TH AVE NE STE 340, ISSAQUAH, WA 98029-5449
(425) 313-3051
(425) 313-3055
Mailing address
510 8TH AVE NE STE 320, ISSAQUAH, WA 98029-5436
(425) 313-3051
(425) 313-3055

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60514402
WA
225XH1200X
Hand Occupational Therapist
OT60514402
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2043476
WA
Enumeration date
03/25/2014
Last updated
11/13/2020
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