Provider Demographics
NPI:1790220226
Name:SIENKO, KATLYN RUTH (OTR)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:RUTH
Last Name:SIENKO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 EAST THIRD STREET MCL2CRED
Mailing Address - Street 2:ESSENTIA HEALTH DULUTH CLINIC
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-3146
Mailing Address - Fax:218-722-8792
Practice Address - Street 1:407 EAST THIRD STREET
Practice Address - Street 2:ESSENTIA HEALTH ST. MARYS MEDICAL CENTER
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-1951
Practice Address - Country:US
Practice Address - Phone:218-786-4000
Practice Address - Fax:218-786-2393
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN105150225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist