Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 017899 | NY |
Y | 225X00000X | Occupational Therapist | OT60414508 | WA |
N | 225XH1200X | Occupational Therapist - Hand | OT60414508 | WA |
NPI | 1023350683 |
---|---|
Provider Name | Mr. Tsu-En Tan |
First Address | Edmonds, WA 98026-8006 |
Second Address | Everett, WA 98201-4833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2013 |
Last Update Date | 10/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0327489 | LABOR AND INDUSTRY DEPARTMENT (01) | WA |
2084605 | (05) | WA |
338249 | WA LABOR & INDUSTRIES (01) | WA |