Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00003732 | WA |
N | 225XH1200X | Occupational Therapist - Hand | OT00003732 | WA |
NPI | 1134398324 |
---|---|
Provider Name | Lisa Walker |
First Address | Everett, WA 98208-7203 |
Second Address | Bellevue, WA 98004-1440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2008 |
Last Update Date | 12/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0089WA | REGENCE (01) | WA |
0257875 | L&I (01) | WA |
0268139 | DEPT OF L&I (01) | WA |
0404WA | REGENCE (01) | WA |
1134398324 | DSHS (01) | WA |
8368714 | DSHS (01) | WA |
9299WA | REGENCE (01) | WA |