Individual
MARY KAITLIN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
501 DATE AVE, SULTAN, WA 98294
(360) 793-9830
Mailing address
22725 22ND DR SE APT A302, BOTHELL, WA 98021-7226
(304) 859-4228
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
60862259
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60862259
OT LICENSE
WA
Enumeration date
01/24/2017
Last updated
08/22/2018
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