Provider Demographics
NPI:1730586264
Name:WALSH, CATHERINE (OTR)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:RUSHING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 2410
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93438-2410
Mailing Address - Country:US
Mailing Address - Phone:360-903-3869
Mailing Address - Fax:
Practice Address - Street 1:805 E WALNUT AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7027
Practice Address - Country:US
Practice Address - Phone:805-735-3714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist