Provider Demographics
NPI:1497290589
Name:WOLCOTT, ASHLEY JANE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:JANE
Last Name:WOLCOTT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:JANE
Other - Last Name:SANDEFUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7714 NE 39TH CT APT W247
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-9275
Mailing Address - Country:US
Mailing Address - Phone:805-794-7966
Mailing Address - Fax:
Practice Address - Street 1:16111 SE MCGILLIVRAY BLVD STE A
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9033
Practice Address - Country:US
Practice Address - Phone:360-253-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61173105225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist