Provider Demographics
NPI:1912323353
Name:NORTHROP, JONATHAN (COTA)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:NORTHROP
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8895 APACHE PLUME DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8903
Mailing Address - Country:US
Mailing Address - Phone:970-689-2005
Mailing Address - Fax:
Practice Address - Street 1:8895 APACHE PLUME DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-8903
Practice Address - Country:US
Practice Address - Phone:970-689-2005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO313703224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant