Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT60040014 | WA |
NPI | 1003068362 |
---|---|
Provider Name | Tamira Bass |
First Address | Kirkland, WA 98033-5948 |
Second Address | Seattle, WA 98104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2008 |
Last Update Date | 06/02/2015 |