Basic Information
Provider Information
NPI: 1003148982
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SWEIGART
FirstName: KATHERINE
MiddleName: MAE
NamePrefix: MRS.
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BELL
OtherFirstName: KATHERINE
OtherMiddleName: MAE
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 4560 SE INTERNATIONAL WAY
Address2: STE. 100
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065202
FaxNumber: 9712065203
Practice Location
Address1: 1301 HIGHLANDS PARKWAY NORTH
Address2:  
City: TACOMA
State: WA
PostalCode: 98406
CountryCode: US
TelephoneNumber: 2537527112
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/03/2010
LastUpdateDate: 02/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT60135957WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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