Healthcare Provider Details

I. General information

NPI: 1174711923
Provider Name (Legal Business Name): KATHLEEN GAIL WAINWRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHY WAINWRIGHT OTR/L, GCFP

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8224 15TH AVE NE
SEATTLE WA
98115-4340
US

IV. Provider business mailing address

8224 15TH AVE. NE
SEATTLE WA
98115
US

V. Phone/Fax

Practice location:
  • Phone: 206-406-0567
  • Fax:
Mailing address:
  • Phone: 206-406-0567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3041
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: