Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OC00000638 | WA |
NPI | 1013278530 |
---|---|
Provider Name | Beverly Renee Beste |
First Address | Federal Way, WA 98003-6385 |
Second Address | Federal Way, WA 98003-6385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2012 |
Last Update Date | 31/05/2012 |