Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter |
NPI | 1780708412 |
---|---|
Provider Name | Mrs. Janet E Weller |
First Address | Tacoma, WA 98405-2308 |
Second Address | Federal Way, WA 98003-8722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 17/05/2013 |