Individual
KARLEE ROSE WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10901 176TH CIR NE, REDMOND, WA 98052-7218
(426) 556-8100
Mailing address
4560 SE INTERNATIONAL WAY STE 101, MILWAUKIE, OR 97222-4628
(971) 206-5202
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC61232941
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OC61232941
—
WA
Enumeration date
04/26/2022
Last updated
04/26/2022
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