Provider Demographics
NPI:1316760382
Name:SANTISTEVAN, JONI (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:JONI
Middle Name:
Last Name:SANTISTEVAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:JONI
Other - Middle Name:
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1605 WOODRIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3818
Mailing Address - Country:US
Mailing Address - Phone:360-443-2399
Mailing Address - Fax:360-443-6121
Practice Address - Street 1:1605 WOODRIDGE DR SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3818
Practice Address - Country:US
Practice Address - Phone:360-443-2399
Practice Address - Fax:360-443-6121
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0001674224Z00000X
WIOC61487586224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant