Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT60804888 | WA |
NPI | 1003323833 |
---|---|
Provider Name | Stephanie Messier |
First Address | Shelton, WA 98584-8225 |
Second Address | Shelton, WA 98584-8225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2018 |
Last Update Date | 02/01/2018 |