Provider Demographics
NPI:1649546383
Name:OTTIS, FELICITY (MOTR/L)
Entity type:Individual
Prefix:
First Name:FELICITY
Middle Name:
Last Name:OTTIS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 SE CASCADE PARK DR
Mailing Address - Street 2:# 60
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8799
Mailing Address - Country:US
Mailing Address - Phone:509-630-0407
Mailing Address - Fax:
Practice Address - Street 1:14000 SE CASCADE PARK DR
Practice Address - Street 2:# 60
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-8799
Practice Address - Country:US
Practice Address - Phone:509-630-0407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR292387225X00000X
WA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist