Healthcare Provider Details

I. General information

NPI: 1104221639
Provider Name (Legal Business Name): KATELYN NICOLE SCHRIPSEMA OTR/L, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYN NICOLE BOS

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 EASTLAKE AVE E
SEATTLE WA
98102-3213
US

IV. Provider business mailing address

11416 BRUSSELS AVE NE
ALBUQUERQUE NM
87111-5212
US

V. Phone/Fax

Practice location:
  • Phone: 206-322-5433
  • Fax:
Mailing address:
  • Phone: 505-750-1635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60974175
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: