Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00003909 | WA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT 00003909 | WA |
NPI | 1073530770 |
---|---|
Provider Name | Ms. Brooke Eytchison |
First Address | Everett, WA 98208-7203 |
Second Address | Bellevue, WA 98004-1440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 17/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005EY | REGENCE (01) | WA |
0015EY | REGENCE (01) | WA |
0016EY | REGENCE (01) | WA |
0017EY | REGENCE (01) | WA |
0034EY | REGENCE (01) | WA |
0040EY | REGENCE (01) | WA |
0257814 | L&I (01) | WA |
0268149 | DEPT OF L&I (01) | WA |
0273694 | L&I (01) | WA |
0297470 | L & I (01) | WA |
1073530770 | DSHS (01) | WA |
6393EY | REGENCE (01) | WA |