Provider Demographics
NPI:1568734523
Name:BOWMAN, KELLY L (OT)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:L
Last Name:BOWMAN
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:L
Other - Last Name:BUNKERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10642 60TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10642 60TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-2412
Practice Address - Country:US
Practice Address - Phone:206-316-7694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60129364225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist