Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 00003542 | WA |
N | 225XE0001X | Environmental Modification | 00003542 | WA |
N | 225XG0600X | Occupational Therapist - Gerontology | 00003542 | WA |
N | 2251H1300X | Human Factors | 00003542 | WA |
N | 225XH1300X | Human Factors | 00003542 | WA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 00003542 | WA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 00003542 | WA |
N | 225XR0403X | Driving and Community Mobility | 00003542 | WA |
NPI | 1154722544 |
---|---|
Provider Name | Raymond Malstead |
First Address | Wenatchee, WA 98801-9649 |
Second Address | Wenatchee, WA 98801-9649 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2014 |
Last Update Date | 13/03/2019 |