Individual
KAYCIE LINN BLANSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
350 S 8TH ST, LEBANON, OR 97355-2242
(541) 259-1221
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
348968
OR
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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