Individual
HEIDI KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
400 29TH ST NE, PUYALLUP, WA 98372
(243) 840-4400
Mailing address
400 29TH ST NE, PUYALLUP, WA 98372-6774
(253) 840-4400
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
60302122
WA
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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