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NPI Code Detail

MEDICARE: JOSHUA BENNETT COTA/L

MEDICARE: JOSHUA BENNETT 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 Assistant
2224Z00000XOccupational Therapy AssistantWA

General Provider Information

NPI Number : 1962170787
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA BENNETT COTA/L
Provider Business Mailing Address
First Line : 724 N 84TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98103-4328
Country : US
Telephone Number : 206-496-2124
Fax Number :
Provider Business Practice Location Address
First Line : 5959 CORSON AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98108-2605
Country : US
Telephone Number : 206-971-7466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2021
Last Update Date : 09/06/2021

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Directions to “ JOSHUA BENNETT COTA/L” Practice Location

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