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General NPI Number Information
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NPI Number | 1154861078
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Entity Type | Individual
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Provider Name | JOHANNA KAUP OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 13023 GREENWOOD AVE N
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City | SEATTLE
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State | WA
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Zip | 98133-7308
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Country | US
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Telephone | 971-206-5202
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Fax |
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Provider Business Mailing Address
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Address Line | 4560 SE INTERNATIONAL WAY STE 100
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City | MILWAUKIE
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State | OR
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Zip | 97222-4628
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT61203301
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License Number State | WA
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