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Individual

MARGO ELENA VANDER WOUDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1322 LATTIMORE RD, FERNDALE, WA 98248-9424
(615) 516-3794
Mailing address
1322 LATTIMORE RD, FERNDALE, WA 98248-9424

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2942
TN
224Z00000X
Occupational Therapy Assistant
Primary
OTA.OC.61347119
WA
225700000X
Massage Therapist
MASS.MA.70155732
WA

Other

Enumeration date
08/16/2017
Last updated
08/03/2026
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