Provider Demographics
NPI:1740262948
Name:KAY, JENNIFER (OTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:KAY
Suffix:
Gender:
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:STACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12911 120TH AVE NE STE G10
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3048
Mailing Address - Country:US
Mailing Address - Phone:425-823-4224
Mailing Address - Fax:425-820-8975
Practice Address - Street 1:1810 116TH AVE NE STE D4
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3058
Practice Address - Country:US
Practice Address - Phone:425-283-5230
Practice Address - Fax:425-283-5236
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001614225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1038075Medicaid