Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 61134714 | WA |
NPI | 1023762754 |
---|---|
Provider Name | Rachel Stanley |
First Address | Olympia, WA 98507-7862 |
Second Address | Gig Harbor, WA 98335-5137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2022 |
Last Update Date | 10/02/2022 |