Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 117609 | TX |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 60961104 | WA |
NPI | 1225687643 |
---|---|
Provider Name | Anna Marie Sales |
First Address | Renton, WA 98057-5466 |
Second Address | Issaquah, WA 98027-5328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2019 |
Last Update Date | 09/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117609 | OT LICENSE (01) | TX |
60961104 | OT LICENSE (01) | WA |