Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 214544 | OR |
N | 225XP0200X | Occupational Therapist - Pediatrics | 214544 | OR |
NPI | 1013112416 |
---|---|
Provider Name | Kristy K Labbe |
First Address | Portland, OR 97213-5536 |
Second Address | Vancouver, WA 98684-5874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 08/07/2007 |