Individual
ANNE NISSILA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
22017 100TH CT SE, KENT, WA 98031-2537
(360) 635-8582
Mailing address
22017 100TH CT SE, KENT, WA 98031-2537
(360) 635-8582
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC 60445101
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OC 60445101
COTA LICENSE
WA
Enumeration date
01/15/2016
Last updated
01/15/2016
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