Provider Demographics
NPI:1730432881
Name:VERNON, CATHERINE (COTA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:VERNON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20420 68TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7405
Mailing Address - Country:US
Mailing Address - Phone:425-670-3063
Mailing Address - Fax:425-431-7511
Practice Address - Street 1:8500 200TH ST SW
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-6627
Practice Address - Country:US
Practice Address - Phone:425-431-3063
Practice Address - Fax:425-431-7511
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC00000118224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant