1932437696 NPI number — MS. LORRAINE RENEE MITCHELL OTR/L

Table of content: MS. LORRAINE RENEE MITCHELL OTR/L (NPI 1932437696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932437696 NPI number — MS. LORRAINE RENEE MITCHELL OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MITCHELL
Provider First Name:
LORRAINE
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MITCHELL
Provider Other First Name:
LORRAINE
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1932437696
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
413 104TH AVENUE COURT E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDGEWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-961-1486
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
413 104TH AVENUE COURT EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDGEWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98372-6011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-961-1486
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OT00001032 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X , with the licence number: OT 12658 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com