Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00003517 | WA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT00003517 | WA |
NPI | 1023180122 |
---|---|
Provider Name | Patricia Groebner |
First Address | Bothell, WA 98021-8972 |
Second Address | Bothell, WA 98021-8972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 25/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8359630 | (05) | WA |