Provider Demographics
NPI:1386184331
Name:MALNATI, MORGAN JENAE (COTA/L)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:JENAE
Last Name:MALNATI
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25140 235TH WAY SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5909
Mailing Address - Country:US
Mailing Address - Phone:206-795-6408
Mailing Address - Fax:
Practice Address - Street 1:25140 235TH WAY SE
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5909
Practice Address - Country:US
Practice Address - Phone:206-795-6408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60711625224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant