Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 232194 | OR |
NPI | 1003011271 |
---|---|
Provider Name | Ms. Margaret Wolf |
First Address | Portland, OR 97209-1351 |
Second Address | Portland, OR 97239-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
225X00000X | TAXONOMY (01) | OR |