Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 978431 | OR |
NPI | 1588917587 |
---|---|
Provider Name | Nancy Lynn Kriet |
First Address | Portland, OR 97215-1675 |
Second Address | Portland, OR 97215-1675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 16/10/2012 |