Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT61044592 | WA |
Y | 225XH1200X | Occupational Therapist - Hand | OT61044592 | WA |
NPI | 1215556485 |
---|---|
Provider Name | Megan Suzanne Thoemke |
First Address | Richland, WA 99352-9532 |
Second Address | Richland, WA 99352-4714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2020 |
Last Update Date | 16/04/2020 |