Provider Demographics
NPI:1366423113
Name:HIJIRIDA, SERINA M (OT)
Entity type:Individual
Prefix:MRS
First Name:SERINA
Middle Name:M
Last Name:HIJIRIDA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SERINA
Other - Middle Name:M
Other - Last Name:IMAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 BROADWAY
Mailing Address - Street 2:STE 440
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5395
Mailing Address - Country:US
Mailing Address - Phone:206-292-6252
Mailing Address - Fax:206-292-7893
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:STE 440
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5395
Practice Address - Country:US
Practice Address - Phone:206-292-6252
Practice Address - Fax:206-292-7893
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003782225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand