Provider Demographics
NPI:1558897348
Name:CUTTER, CHARLES ARTHUR III (MOT, OTR/L SWC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ARTHUR
Last Name:CUTTER
Suffix:III
Gender:M
Credentials:MOT, OTR/L SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20446 CORBRIDGE RD SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-9693
Mailing Address - Country:US
Mailing Address - Phone:510-332-6341
Mailing Address - Fax:
Practice Address - Street 1:20446 CORBRIDGE RD SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-9693
Practice Address - Country:US
Practice Address - Phone:510-332-6341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61438518225X00000X, 225XP0200X, 225XF0002X
CAOT266225X00000X, 225XF0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics