Basic Information
Provider Information
NPI: 1508317496
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WASH
FirstName: HANNAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MOT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 5281 N 99TH AVE STE 200
Address2:  
City: GLENDALE
State: AZ
PostalCode: 853053199
CountryCode: US
TelephoneNumber: 6238890411
FaxNumber: 6238890410
Practice Location
Address1: 9097 E DESERT COVE AVE STE 110
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852606276
CountryCode: US
TelephoneNumber: 4805651897
FaxNumber: 4808600356
Other Information
ProviderEnumerationDate: 10/17/2016
LastUpdateDate: 10/17/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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