Provider Demographics
NPI:1760622112
Name:HOGLUND, JAYME KATHARINE
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:KATHARINE
Last Name:HOGLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:KATHARINE
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:625 OKANOGAN AVE
Mailing Address - Street 2:COLONIAL VISTA CARE CENTERS
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-663-1171
Mailing Address - Fax:509-665-7390
Practice Address - Street 1:625 OKANOGAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:971-206-5200
Practice Address - Fax:971-206-5203
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60062780225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist