Provider Demographics
NPI:1306667852
Name:MACRAE, MERIDETH MICHELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:MERIDETH
Middle Name:MICHELLE
Last Name:MACRAE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11449 BRISTOL PL
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-9791
Mailing Address - Country:US
Mailing Address - Phone:425-503-8722
Mailing Address - Fax:
Practice Address - Street 1:2689 HOOVER AVE SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3013
Practice Address - Country:US
Practice Address - Phone:360-443-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist