Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT 60004325 | WA |
NPI | 1013267012 |
---|---|
Provider Name | Christine Mathews-Dalton |
First Address | Shoreline, WA 98133-5531 |
Second Address | Shoreline, WA 98133-5531 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2012 |
Last Update Date | 17/09/2012 |