Provider Demographics
NPI:1982478210
Name:BRUCE, KADY ELIZABETH (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:KADY
Middle Name:ELIZABETH
Last Name:BRUCE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 SW MCFADDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-4709
Mailing Address - Country:US
Mailing Address - Phone:360-736-0086
Mailing Address - Fax:
Practice Address - Street 1:1336 SW MCFADDEN AVE
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-4709
Practice Address - Country:US
Practice Address - Phone:360-736-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61494554225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist