Provider Demographics
NPI:1912463969
Name:GONSALEZ, YANET (OT)
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:GONSALEZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:YANET
Other - Middle Name:
Other - Last Name:BRAVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:906 SE EVERETT MALL WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3743
Mailing Address - Country:US
Mailing Address - Phone:425-353-5656
Mailing Address - Fax:
Practice Address - Street 1:906 SE EVERETT MALL WAY STE 200
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3743
Practice Address - Country:US
Practice Address - Phone:425-353-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics