Provider Demographics
NPI:1285896761
Name:WESSON, DEBRA C (OTR)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:C
Last Name:WESSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 GUERRIER RD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-8502
Mailing Address - Country:US
Mailing Address - Phone:360-262-9696
Mailing Address - Fax:
Practice Address - Street 1:128 OLD BEACON HILL DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-5854
Practice Address - Country:US
Practice Address - Phone:360-423-4060
Practice Address - Fax:360-578-5983
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001853225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist