Provider Demographics
NPI:1548016074
Name:CROUCH, KARLA RUTH (OTR/L, MOT)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:RUTH
Last Name:CROUCH
Suffix:
Gender:F
Credentials:OTR/L, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 5TH AVE S STE 103
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3585
Mailing Address - Country:US
Mailing Address - Phone:206-793-8388
Mailing Address - Fax:
Practice Address - Street 1:505 5TH AVE S STE 103
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3585
Practice Address - Country:US
Practice Address - Phone:206-499-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61525993225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist