Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT00003865 | WA |
N | 2251E1200X | Ergonomics | OT00003865 | WA |
N | 225XE1200X | Ergonomics | OT00003865 | WA |
Y | 225XH1200X | Occupational Therapist - Hand | OT00003865 | WA |
NPI | 1255321618 |
---|---|
Provider Name | Megan Bristow |
First Address | Spokane Valley, WA 99216-1097 |
Second Address | Spokane, WA 99204-2705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 21/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
650009047 | RAILROAD MEDICARE (01) | WA |
8390395 | (05) | WA |
CN2416 | RAILROAD MEDICARE GROUP (01) | WA |
P00146690 | RAILROAD MEDICARE INDIVIDUAL (01) | WA |