Provider Demographics
NPI:1558509083
Name:WATSON, MICHAELA J (OTD)
Entity Type:Individual
Prefix:DR
First Name:MICHAELA
Middle Name:J
Last Name:WATSON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 COUNTY ROAD 17
Mailing Address - Street 2:
Mailing Address - City:CERESCO
Mailing Address - State:NE
Mailing Address - Zip Code:68017-4041
Mailing Address - Country:US
Mailing Address - Phone:402-417-5249
Mailing Address - Fax:
Practice Address - Street 1:430 NW ISLAND CIR
Practice Address - Street 2:APT B5
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8363
Practice Address - Country:US
Practice Address - Phone:402-417-5249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist