Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 00003441 | WA |
Y | 225XH1200X | Occupational Therapist - Hand | OT00003441 | WA |
NPI | 1245548338 |
---|---|
Provider Name | Kathleen Marie Nielsen |
First Address | Seattle, WA 98104-1172 |
Second Address | Bellevue, WA 98004-3058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2010 |
Last Update Date | 16/08/2016 |