Healthcare Provider Details

I. General information

NPI: 1184385460
Provider Name (Legal Business Name): LAURA CATHERINE KREBSER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 STEILACOOM BLVD SW
LAKEWOOD WA
98498-7212
US

IV. Provider business mailing address

601 THOMAS ST NW
OLYMPIA WA
98502-4783
US

V. Phone/Fax

Practice location:
  • Phone: 253-984-4172
  • Fax:
Mailing address:
  • Phone: 360-819-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOT61017518
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: