Provider Demographics
NPI:1598955379
Name:ALQUIST, KIMBERLY A (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:ALQUIST
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 216TH ST SW STE 320
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-741-0056
Mailing Address - Fax:425-741-0057
Practice Address - Street 1:19031 33RD AVE W STE 102
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4724
Practice Address - Country:US
Practice Address - Phone:425-741-0056
Practice Address - Fax:425-741-0057
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001174225XH1200X, 225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA469979OtherWA L&I
WA1041882Medicaid