Provider Demographics
NPI:1255472429
Name:OCZKEWICZ, ROBYNN L (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:ROBYNN
Middle Name:L
Last Name:OCZKEWICZ
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:MS
Other - First Name:ROBYNN
Other - Middle Name:L
Other - Last Name:STOLTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:10505 19TH AVE SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4280
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3726 BROADWAY
Practice Address - Street 2:SUITE 104
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3787
Practice Address - Country:US
Practice Address - Phone:425-252-4600
Practice Address - Fax:425-252-4477
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003685225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0279548OtherL & I
WA1255472429Medicaid
WAG8900664OtherMEDICARE NON-KING CO.