Individual
JENNIFER WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1310 NW DEANE ST, PULLMAN, WA 99163-3705
(506) 332-1566
Mailing address
1010 S 336TH ST STE 210, FEDERAL WAY, WA 98003-7354
(866) 835-8091
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60506537
WA
Other
Enumeration date
09/18/2017
Last updated
03/17/2018
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