Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 282954 | OR |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT 00001254 | WA |
NPI | 1023326253 |
---|---|
Provider Name | Elizabeth Jane Mcphee |
First Address | Portland, OR 97219-4147 |
Second Address | Vancouver, WA 98661-6812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2010 |
Last Update Date | 22/09/2010 |