Provider Demographics
NPI:1467706721
Name:BARNETT, MICHELLE KAY (COTA/L)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KAY
Last Name:BARNETT
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 1:15306 B STREET EAST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-3055
Mailing Address - Country:US
Mailing Address - Phone:206-406-3171
Mailing Address - Fax:
Practice Address - Street 1:31312 107TH PL SE
Practice Address - Street 2:C1
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-3053
Practice Address - Country:US
Practice Address - Phone:206-458-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60252345224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant