Individual
JAN MICHELLE KITTLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
22813 CAREY RD SW, VASHON, WA 98070-6819
(206) 463-5788
Mailing address
22813 CAREY RD SW, VASHON, WA 98070-6819
(206) 463-5788
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
00001400
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT 00001400
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
12/07/2010
Last updated
12/07/2010
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