Provider Demographics
NPI:1699166884
Name:TOOMB, PAULINE ELAINE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:ELAINE
Last Name:TOOMB
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 1:22443 SE 240TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5898
Mailing Address - Country:US
Mailing Address - Phone:425-358-3070
Mailing Address - Fax:425-413-6797
Practice Address - Street 1:22443 SE 240TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5898
Practice Address - Country:US
Practice Address - Phone:425-358-3070
Practice Address - Fax:425-413-6797
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60530454224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant