Provider Demographics
NPI:1043594088
Name:BRIGGS, KAYLA M (MS OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:M
Last Name:BRIGGS
Suffix:
Gender:X
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 NE 134TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-3036
Mailing Address - Country:US
Mailing Address - Phone:360-504-0122
Mailing Address - Fax:360-859-1354
Practice Address - Street 1:221 MOLALLA AVE STE 102
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-3072
Practice Address - Country:US
Practice Address - Phone:971-256-6642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR288801225X00000X
WAOT60685229225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47065477702Medicaid