Individual
JACLYN NOEL SPATARO WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4560 SE INTERNATIONAL WAY, STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5102
Mailing address
4560 SE INTERNATIONAL WAY, STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004276
IL
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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