Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OC60466169 | WA |
NPI | 1013319565 |
---|---|
Provider Name | Rachel Sivils |
First Address | Spanaway, WA 98387-8335 |
Second Address | Spanaway, WA 98387-8335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2014 |
Last Update Date | 16/09/2014 |