Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251P0200X | Physical Therapist - Pediatrics | PT00003014 | WA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT00000368 | WA |
NPI | 1033273115 |
---|---|
Provider Name | Janine Louise Czerniecki |
First Address | Seattle, WA 98103-7625 |
Second Address | Millcreek, WA 98012-1273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0368CZ | REGENCE OT PIN (01) | WA |
8348294 | (05) | WA |
8367575 | (05) | WA |
R36130 | REGENCE PT PIN (01) | WA |