Healthcare Provider Details

I. General information

NPI: 1992049423
Provider Name (Legal Business Name): KAVITA S PATEL OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2012
Last Update Date: 11/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 NW 95TH ST
SEATTLE WA
98117-2207
US

IV. Provider business mailing address

820 NW 95TH ST
SEATTLE WA
98117-2207
US

V. Phone/Fax

Practice location:
  • Phone: 206-781-6800
  • Fax: 505-468-3838
Mailing address:
  • Phone: 206-781-6800
  • Fax: 505-468-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 60059349
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: