Most Relevant Information
Provider Data
| NPI Number: | 1003490012 |
| Provider Name: | KAYLEE BAZE COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 426792 |
Most Important Dates
| Enumeration Date: | 05/06/2021 |
| Last Updated: | 05/06/2021 |
Provider Practice Location
4515 SUNNYSIDE RD SE
SALEM
OR
973023954
Practice Location Phone/Fax
| Phone: | 5033708285 |
| Fax: |
Provider Mailing Location
334 EAGLES WING ST NW
SALEM
OR
973044263
Provider Mailing Phone/Fax
| Phone: | 5038718586 |
| Fax: |