Healthcare Provider Details

I. General information

NPI: 1609647916
Provider Name (Legal Business Name): MONTE KUHN OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13613 MERIDIAN E
PUYALLUP WA
98373-3664
US

IV. Provider business mailing address

13613 MERIDIAN E
PUYALLUP WA
98373-3664
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-7916
  • Fax:
Mailing address:
  • Phone: 253-838-7916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT00003164
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: