Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00001822 | WA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT00001822 | WA |
NPI | 1588855233 |
---|---|
Provider Name | Mrs. Katherine Marie Leon |
First Address | Washougal, WA 98671-7633 |
Second Address | Washougal, WA 98671-7633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 07/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7683147 | (05) | WA |