Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC 60502772 | WA |
NPI | 1013305150 |
---|---|
Provider Name | Bettina Kathleen Eklund |
First Address | Puyallup, WA 98372-6782 |
Second Address | Puyallup, WA 98372-6782 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2014 |
Last Update Date | 23/12/2014 |