Provider Demographics
NPI:1104221639
Name:SCHRIPSEMA, KATELYN NICOLE (OTR/L, MT-BC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:NICOLE
Last Name:SCHRIPSEMA
Suffix:
Gender:F
Credentials:OTR/L, MT-BC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:NICOLE
Other - Last Name:BOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11416 BRUSSELS AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-5212
Mailing Address - Country:US
Mailing Address - Phone:505-750-1635
Mailing Address - Fax:
Practice Address - Street 1:2627 EASTLAKE AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3213
Practice Address - Country:US
Practice Address - Phone:206-322-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225A00000X
WAOT60974175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist