Provider Demographics
NPI:1083452254
Name:HADLEY, RAEGAN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:
Last Name:HADLEY
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10511 19TH AVE SE STE B
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4279
Mailing Address - Country:US
Mailing Address - Phone:425-357-8885
Mailing Address - Fax:
Practice Address - Street 1:10511 19TH AVE SE STE B
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4279
Practice Address - Country:US
Practice Address - Phone:425-357-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist