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Individual

KATHERINE J. SKOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
16030 BOTHELL EVERETT HWY STE 140, MILL CREEK, WA 98012-1273
(425) 338-9005
Mailing address
1120 MILL CREEK BLVD # D208, MILL CREEK, WA 98012-3016
(425) 385-3148

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT00004051
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8074SK
REGENCE PIN#
WA
05
8426694
WA
Enumeration date
10/06/2006
Last updated
07/08/2007
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