Provider Demographics
NPI:1962684928
Name:MARTINEAU, TAWNYA R (COTA)
Entity Type:Individual
Prefix:
First Name:TAWNYA
Middle Name:R
Last Name:MARTINEAU
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 GEORGIA AVENUE SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-735-1062
Mailing Address - Fax:509-737-8492
Practice Address - Street 1:1549 GEORGIA AVENUE SE
Practice Address - Street 2:SUITE A
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-735-1062
Practice Address - Fax:509-737-8492
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC00000893224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant