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NPI Code Detail

MEDICARE: DANELL RENE ANDERSON COTA/L

MEDICARE: DANELL RENE ANDERSON COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOC60395879WA

General Provider Information

NPI Number : 1902751076
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANELL RENE ANDERSON COTA/L
Provider Business Mailing Address
First Line : 10011 BUNK FOSS RD
Second Line :
City : SNOHOMISH
State : WA
Zip : 98290-5714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1355 W MAIN ST
Second Line :
City : MONROE
State : WA
Zip : 98272-2022
Country : US
Telephone Number : 360-794-4011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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