Provider Demographics
NPI:1063056414
Name:POINSETTE, TRICIA ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANN
Last Name:POINSETTE
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:PO BOX 783
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-0783
Mailing Address - Country:US
Mailing Address - Phone:541-400-8769
Mailing Address - Fax:
Practice Address - Street 1:418 NE TOHOMISH ST.
Practice Address - Street 2:SUITE 300
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672
Practice Address - Country:US
Practice Address - Phone:541-400-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61516780225X00000X
OR505439225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist