Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT00000845 | WA |
NPI | 1023362753 |
---|---|
Provider Name | Ms. Donna Shaman |
First Address | Seattle, WA 98118-2860 |
Second Address | Burien, WA 98166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2012 |
Last Update Date | 02/11/2012 |