Provider Demographics
NPI:1629344635
Name:BAULING, KATHERINE MICHELLE (MOTS/L)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MICHELLE
Last Name:BAULING
Suffix:
Gender:F
Credentials:MOTS/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11702 N FAIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2927
Mailing Address - Country:US
Mailing Address - Phone:509-991-4323
Mailing Address - Fax:
Practice Address - Street 1:200 N BERNARD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0206
Practice Address - Country:US
Practice Address - Phone:509-354-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60269562174400000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist