Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1003057357 |
---|---|
Provider Name | Lori Hughes Roshau |
First Address | North Bend, WA 98045-8262 |
Second Address | North Bend, WA 98045-8262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2009 |
Last Update Date | 17/03/2009 |