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Individual

MRS. CATHERINE WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
1315 NW 4TH ST, SUITE B, REDMOND, OR 97756-1328
(541) 923-7494
(541) 504-9153
Mailing address
PO BOX 24988, SEATTLE, WA 98124-0988
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1066077
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
339238
PROVIDENCE
01
H254810
PACIFIC SOURCE BCBS
OR
Enumeration date
02/13/2006
Last updated
10/15/2007
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