Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00004233 | WA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT00004233 | WA |
NPI | 1992072631 |
---|---|
Provider Name | Mrs. Laura Lee Rodeman |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2011 |
Last Update Date | 15/04/2020 |