Provider Demographics
NPI:1093578213
Name:ATKINS, GAYLE ANNE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:ANNE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360-0478
Mailing Address - Country:US
Mailing Address - Phone:206-354-8499
Mailing Address - Fax:
Practice Address - Street 1:1301 ORTING KAPOWSIN HWY E
Practice Address - Street 2:
Practice Address - City:ORTING
Practice Address - State:WA
Practice Address - Zip Code:98360-9550
Practice Address - Country:US
Practice Address - Phone:360-893-4515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60186571224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty