Provider Demographics
NPI:1417336611
Name:SOSA, FAITH (COTA)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:SOSA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:ARCHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9102 63RD AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6263
Mailing Address - Country:US
Mailing Address - Phone:253-380-0759
Mailing Address - Fax:
Practice Address - Street 1:9102 63RD AVENUE CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6263
Practice Address - Country:US
Practice Address - Phone:253-380-0759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60566146224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant