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Individual

ERICA KAYLIN GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
5455 CONVERSE AVE SE, PORT ORCHARD, WA 98367-7809
(360) 874-6400
Mailing address
11849 MAJESTIC LN NW APT 103, SILVERDALE, WA 98383-7934
(618) 910-0549

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.005553
IL
224Z00000X
Occupational Therapy Assistant
Primary
61379515
WA

Other

Enumeration date
04/02/2021
Last updated
01/12/2024
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