Provider Demographics
NPI:1609758846
Name:RASMUSSEN, ALYSEN G (COTA, L)
Entity type:Individual
Prefix:
First Name:ALYSEN
Middle Name:G
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:COTA, L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 S CUSHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-2535
Mailing Address - Country:US
Mailing Address - Phone:406-291-6869
Mailing Address - Fax:
Practice Address - Street 1:4014 S CUSHMAN AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-2535
Practice Address - Country:US
Practice Address - Phone:406-291-6869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOTA.OC.70010951224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant