Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT00000749 | WA |
N | 225XG0600X | Occupational Therapist - Gerontology | OT00000749 | WA |
Y | 225XG0600X | Occupational Therapist - Gerontology | OT0000749 | WA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT00000749 | WA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT00000749 | WA |
NPI | 1043503790 |
---|---|
Provider Name | Mrs. Karen L St. Charles |
First Address | North Bend, WA 98045 |
Second Address | North Bend, WA 98045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2011 |
Last Update Date | 28/03/2012 |