Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT00000329 | WA |
NPI | 1164501268 |
---|---|
Provider Name | Alex G. Bartl |
First Address | Bellingham, WA 98226-9028 |
Second Address | Bellingham, WA 98225-1759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |