Provider Demographics
NPI:1174041933
Name:OSBORN, KAILA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:OSBORN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:KAILA
Other - Middle Name:
Other - Last Name:HIATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:904 SW 118TH ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-2723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12033 SE 256TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7000
Practice Address - Country:US
Practice Address - Phone:253-373-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60737705225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist