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Individual

WILLIAM SLATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5202
Mailing address
10429 LITTLEROCK RD SW, OLYMPIA, WA 98512-9329

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60574020
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
224Z00000X
COTA/L
WA
Enumeration date
02/15/2021
Last updated
02/15/2021
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