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Individual

MRS. KATHERINE MARIE LEON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
711 RIVERSIDE DR, WASHOUGAL, WA 98671-7633
(360) 837-3138
Mailing address
711 RIVERSIDE DR, WASHOUGAL, WA 98671-7633
(360) 837-3138

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001822
WA
225XN1300X
Neurorehabilitation Occupational Therapist
OT00001822
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7683147
WA
Enumeration date
08/07/2007
Last updated
08/07/2007
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