Marchelle Wilson, COTA/L
Individual provider Active NPI Contractor · Cle Elum, WA
NPI 1346580321 · NPPES record last updated Feb 27, 2013
Key facts
- NPI
- 1346580321
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- OC60100676 (WA)
- Practice address
- 2690 Sr 903
Cle Elum, WA 98922 - Phone
- (509) 649-4707
- Fax
- (509) 649-3634
- NPI assigned
- Feb 27, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OC60100676 | WA | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | OC60100676 | WA | Yes |
Addresses
Primary practice location
2690 Sr 903
Cle Elum, WA 98922
Mailing address
2690 Sr 903
Cle Elum, WA 98922
Phone (509) 649-4707
Other providers in Cle Elum, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.