Provider Demographics
NPI:1750690889
Name:YOUNG, ASHLEE LYNN (COTA/L)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:LYNN
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7422 NE 59TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-5953
Mailing Address - Country:US
Mailing Address - Phone:360-713-3343
Mailing Address - Fax:
Practice Address - Street 1:7422 NE 59TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-5953
Practice Address - Country:US
Practice Address - Phone:360-713-3343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC00001188224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant