Provider Demographics
NPI:1316053689
Name:SILVA, JUDY B (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:B
Last Name:SILVA
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 1:29705 48TH AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-1504
Mailing Address - Country:US
Mailing Address - Phone:253-632-3964
Mailing Address - Fax:253-661-0772
Practice Address - Street 1:1615 S 325TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6009
Practice Address - Country:US
Practice Address - Phone:253-661-0041
Practice Address - Fax:253-661-0772
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT03939225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT03939OtherOTR LICENSE