Healthcare Provider Details

I. General information

NPI: 1982923926
Provider Name (Legal Business Name): EMILY C PARRY COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 EAST 72ND STREET
TACOMA WA
98404
US

IV. Provider business mailing address

4560 SE INTERNATIONAL WAY SUITE 100 CONSONUS HEALTHCARE SERVICES
MILWAUKIE OR
97222
US

V. Phone/Fax

Practice location:
  • Phone: 253-472-9027
  • Fax: 253-474-6258
Mailing address:
  • Phone: 971-206-5166
  • Fax: 971-206-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOC60143794
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: