Individual
MIKAYLA RENAE WASSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1620 S PIONEER WAY, MOSES LAKE, WA 98837-2487
(509) 766-2670
(509) 766-2689
Mailing address
1620 S PIONEER WAY, MOSES LAKE, WA 98837-2487
(509) 766-2670
(509) 766-2689
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT61052997
WA
Other
Enumeration date
09/22/2020
Last updated
12/05/2024
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