Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT60518116 | WA |
Y | 225XF0002X | Feeding, Eating & Swallowing | OT60518116 | WA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT60518116 | WA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT60518116 | WA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT60518116 | WA |
NPI | 1164828117 |
---|---|
Provider Name | Amanda Kelly Panotes |
First Address | Kent, WA 98030-7108 |
Second Address | Kent, WA 98030-7108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 18/11/2014 |