Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT00003187 | WA |
Y | 2251H1200X | Hand | PT00003187 | WA |
NPI | 1750493565 |
---|---|
Provider Name | Karyn A. Mori |
First Address | Seattle, WA 98104-1132 |
Second Address | Seattle, WA 98122-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 22/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0288284 | L & I (01) | WA |
0288353 | L & I (01) | WA |