Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 96263 | OR |
NPI | 1114030699 |
---|---|
Provider Name | Mrs. Diana Watsky Sirkin |
First Address | Clackamas, OR 97015-9303 |
Second Address | Clackamas, OR 97015-8970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 16/07/2007 |