Healthcare Provider Details

I. General information

NPI: 1124408091
Provider Name (Legal Business Name): KATHRYN ANNE GEDRIMAS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 BENSON RD S
RENTON WA
98055-5106
US

IV. Provider business mailing address

2640 BENSON RD S
RENTON WA
98055-5106
US

V. Phone/Fax

Practice location:
  • Phone: 425-336-3260
  • Fax:
Mailing address:
  • Phone: 425-336-3260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60731642
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: