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General NPI Number Information
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NPI Number | 1871369678
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Entity Type | Individual
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Provider Name | MAUREEN DAIBER COTA
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Gender | Female
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Dates
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Enumeration Date | 12/01/2023
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 32049 109TH PL SE
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City | AUBURN
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State | WA
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Zip | 98092-2567
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Country | US
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Telephone | 971-206-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 12709 SE 306TH ST
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City | AUBURN
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State | WA
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Zip | 98092-3196
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Country | US
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Telephone | 206-200-2889
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OC00000338
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License Number State | WA
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