Holly Fae Mahoney, OTR/L
Occupational Therapist in Vancouver, WA. Individual provider (NPI-1).
NPI number1376840652
StatusActive
Last updated in NPPESJul 27, 2016
Details
- NPI
- 1376840652
- Entity type
- Individual (NPI-1)
- Name
- Holly Fae Mahoney
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 22, 2011
- Last updated
- Jul 27, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 281069 | OR | Yes |
Other names
- Holly Fae Brydl-Andrews (Former Name)
Practice location
2500 Ne 65th AveVancouver, WA 98661-6812
Phone 402-641-0919
Mailing address
2500 Ne 65th AveVancouver, WA 98661-6812
Phone 402-641-0919
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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