Provider Demographics
NPI:1215324538
Name:GREGORIOS, ANGELEIGH (OTR/L)
Entity type:Individual
Prefix:
First Name:ANGELEIGH
Middle Name:
Last Name:GREGORIOS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANGELEIGH
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2009 247TH PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98074-3343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14431 REDMOND WAY
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4245
Practice Address - Country:US
Practice Address - Phone:425-869-2273
Practice Address - Fax:847-386-5806
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00003327225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology