Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT00001152 | WA |
Y | 225XH1200X | Occupational Therapist - Hand | OT00001152 | WA |
NPI | 1124060405 |
---|---|
Provider Name | Diane M Newman-Branch |
First Address | Silverdale, WA 98383-8502 |
Second Address | Silverdale, WA 98383-7681 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198209 | LABOR & INDUSTRIES (01) | WA |
8351520 | (05) | WA |
8906174 | CRIME VICTIMS COMP (01) | WA |
8918NE | REGENCE BLUESHIELD (01) | |
P00391583 | RAILROAD MEDICARE (01) | |
P26849 | (02) |