Provider Demographics
NPI:1285113126
Name:HOWARD, KATHRYN NELL (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:NELL
Last Name:HOWARD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:NELL
Other - Last Name:MOSELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:750 SW THORNBERRY DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8974
Mailing Address - Country:US
Mailing Address - Phone:757-816-5247
Mailing Address - Fax:
Practice Address - Street 1:316 E MCLEOD RD STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6491
Practice Address - Country:US
Practice Address - Phone:360-734-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60869649224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant