Individual
KERRIE ANN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10637 SE 238TH ST APT B, KENT, WA 98031-3571
(206) 412-5722
Mailing address
10637 SE 238TH ST APT B, KENT, WA 98031-3571
(206) 412-5722
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC 60315592
WA
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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