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Individual

KATE E SISCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR-L

Contact information

Practice address
3901 CAPITAL MALL DR SW, SUITE D, OLYMPIA, WA 98502-8654
(360) 709-6221
(360) 359-4727
Mailing address
PO BOX 368, OLYMPIA, WA 98507-0368
(360) 413-3842

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00003444
WA
225XH1200X
Hand Occupational Therapist
OT00003444
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0214998
DEPT. OF LABOR & INDUSTRY
WA
01
2179HA
REGENCE BLUE SHIELD
WA
01
4169HA
REGENCE BLUE SHIELD
WA
01
6840KI
REGENCE
WA
01
6910HA
REGENCE BLUE SHIELD
WA
01
710883456-98502-A003
TRICARE
WA
01
710883456-98503-A006
TRICARE
WA
01
710883456-98512-A004
TRICARE
WA
01
7328573
AETNA
WA
05
8341331
WA
01
8430KI
REGENCE
WA
01
8943009
L&I CRIME VICTIMS
WA
01
P00639804
RAILROAD MEDICARE
WA
Enumeration date
11/02/2006
Last updated
11/08/2019
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