Provider Demographics
NPI:1730291519
Name:STOCKMAN, PAMELA L (OTR/L)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:STOCKMAN
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 1:6900 37TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6425
Mailing Address - Country:US
Mailing Address - Phone:253-677-3212
Mailing Address - Fax:253-677-3212
Practice Address - Street 1:6900 37TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6425
Practice Address - Country:US
Practice Address - Phone:253-677-3212
Practice Address - Fax:253-677-3212
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist