Provider Demographics
NPI:1528739299
Name:PALMER, ROBIN LORRAINE (OTR/L)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LORRAINE
Last Name:PALMER
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 1:108 5TH AVE S UNIT 711
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2376
Mailing Address - Country:US
Mailing Address - Phone:707-630-2276
Mailing Address - Fax:
Practice Address - Street 1:2127 HARRISON AVE STE 3
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3241
Practice Address - Country:US
Practice Address - Phone:707-630-2276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty