Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1025293 | OR |
NPI | 1003949140 |
---|---|
Provider Name | Mrs. Heather Kristine Welker |
First Address | Bend, OR 97701-7752 |
Second Address | Bend, OR 97703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 12/07/2018 |