MEDICARE: DR. AMBER KATELYN JEROMCHEK OTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT61130134	WA
2	225X00000X	Occupational Therapist	446053	OR

General Provider Information

NPI Number	:	1518625508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER KATELYN JEROMCHEK OTD

Provider Business Mailing Address
First Line	:	9040A JACKSON AVE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9040 JACKSON AVE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-9098
Country	:	US
Telephone Number	:	253-968-1110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2021
Last Update Date	:	01/13/2026

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