Provider Demographics
NPI:1326372707
Name:WITTERS, KAREN ALLEN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ALLEN
Last Name:WITTERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18303 74TH ST E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-7027
Mailing Address - Country:US
Mailing Address - Phone:253-377-6285
Mailing Address - Fax:
Practice Address - Street 1:324 E PIONEER
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3264
Practice Address - Country:US
Practice Address - Phone:253-377-6285
Practice Address - Fax:253-693-2016
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000593225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist