Individual
THOMAS KELLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
835 MADISON AVE N, BAINBRIDGE ISLAND, WA 98110-1700
(206) 842-4765
Mailing address
835 MADISON AVE N, BAINBRIDGE ISLAND, WA 98110-1700
(206) 842-4765
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0C00000849
WA
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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