Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 1031476 | OR |
N | 225XH1200X | Occupational Therapist - Hand | OT00003250 | WA |
NPI | 1164405742 |
---|---|
Provider Name | Katherine A Stevens |
First Address | Portland, OR 97210-3442 |
Second Address | Portland, OR 97210-3442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 16/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098565014 | BCBSO (01) | OR |
130651 | WA L&I (01) | WA |
231754 | (05) | OR |
8419939 | (05) | WA |