Provider Demographics
NPI:1376691592
Name:ELVINS, CATHRYN (OTR L)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:ELVINS
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 1:4411 POINT FOSDICK DR NW STE 101
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1703
Mailing Address - Country:US
Mailing Address - Phone:253-851-7472
Mailing Address - Fax:253-851-7473
Practice Address - Street 1:4411 POINT FOSDICK DR NW STE 101
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1703
Practice Address - Country:US
Practice Address - Phone:253-851-7472
Practice Address - Fax:253-851-7473
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT0000768225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA128756OtherL&I
P00271866OtherRR MC
WA8369332Medicaid
WA7472ELOtherREGENCE GH
WA5872ELOtherREGENCE TACOMA
WA8369332Medicaid