Individual
SHANNON MCGARRY WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1800 INDEX AVE NE, RENTON, WA 98056-2314
(425) 224-2200
Mailing address
15517 27TH DR SE, MILL CREEK, WA 98012-4845
(425) 308-2509
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60821432
WA
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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