Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 60884736 | WA |
NPI | 1013496611 |
---|---|
Provider Name | Allyson Elizabeth Bonde |
First Address | Marysville, WA 98270-3775 |
Second Address | Burlington, WA 98233-1918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2018 |
Last Update Date | 21/09/2021 |