Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 60825218 | WA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 60825218 | WA |
NPI | 1023514288 |
---|---|
Provider Name | Megan Chain |
First Address | Bellingham, WA 98225-3641 |
Second Address | Bellingham, WA 98225-3226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 04/04/2018 |