Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | OT 6976 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | OT00004496 | WA |
NPI | 1184655490 |
---|---|
Provider Name | Ms. Margaret Grace Siemer |
First Address | Everett, WA 98208-4280 |
Second Address | Lake Stevens, WA 98258-1937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 21/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT00004496 | WA LICENSE (01) | WA |
OT0069760 | BLUE SHIELD (01) | CA |