Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT61193276 | WA |
NPI | 1003580820 |
---|---|
Provider Name | Alyssa Griffin |
First Address | Bothell, WA 98012-8168 |
Second Address | Bothell, WA 98011-1927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2021 |
Last Update Date | 04/08/2021 |