Individual
MRS. KRISTA BETH MERTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3801 5TH ST SE STE 220, PUYALLUP, WA 98374-2106
(253) 445-4258
(253) 445-4724
Mailing address
5210 CORPORATE CENTER CT SE, SUITE D, LACEY, WA 98503-5952
(360) 455-8155
(360) 455-1655
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001454
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0264702
DEPT OF L&I
WA
01
—
0319ME
REGENCE
WA
01
—
1518031467
DSHS
WA
05
—
8368946
—
WA
01
—
LI0192217
LABOR & INDUSTRIES
—
Enumeration date
11/20/2006
Last updated
07/10/2019
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