Provider Demographics
NPI:1548290448
Name:MASON, KATHERINE E (OT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:MASON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:E
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 731269
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-0060
Mailing Address - Country:US
Mailing Address - Phone:253-840-2313
Mailing Address - Fax:253-840-6340
Practice Address - Street 1:3912 10TH ST SE
Practice Address - Street 2:SUITE 101
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-2188
Practice Address - Country:US
Practice Address - Phone:253-848-4700
Practice Address - Fax:253-848-2284
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002163225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8931497OtherCRIME VICTIMS
WA5088MAOtherREGENCE BLUE SHIELD
WA178356OtherDEPT OF LABOR & INDUSTRIE
WA8368920Medicaid
WA8368920Medicaid