Provider Demographics
NPI:1790975738
Name:PHILLIPS, KATHRYN LOUISE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:LOUISE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S UNIVERSITY RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5555
Mailing Address - Country:US
Mailing Address - Phone:509-924-4650
Mailing Address - Fax:509-228-0851
Practice Address - Street 1:414 S UNIVERSITY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5555
Practice Address - Country:US
Practice Address - Phone:509-924-4650
Practice Address - Fax:509-228-0851
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1043225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist