Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00002911 | WA |
NPI | 1003164807 |
---|---|
Provider Name | Jennifer Weeks |
First Address | Lakewood, WA 98499-1341 |
Second Address | Lakewood, WA 98499-1341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2012 |
Last Update Date | 09/04/2013 |