Provider Demographics
NPI:1669018107
Name:FOSTER, KENDRA JANINE (ORL/L, OTD)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:JANINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:ORL/L, OTD
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:JANINE
Other - Last Name:SCHNACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26997 152ND STREET
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:IA
Mailing Address - Zip Code:51526
Mailing Address - Country:US
Mailing Address - Phone:402-619-1844
Mailing Address - Fax:
Practice Address - Street 1:26997 152ND STREET
Practice Address - Street 2:
Practice Address - City:CRESCENT
Practice Address - State:IA
Practice Address - Zip Code:51526
Practice Address - Country:US
Practice Address - Phone:402-619-1844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60974029225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT60974029OtherWASHINGTON STATE LICENSE/CREDENTIAL