Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 60805159 | WA |
NPI | 1033610670 |
---|---|
Provider Name | Timber Anderson |
First Address | Seattle, WA 98109-2288 |
Second Address | Seattle, WA 98109-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2018 |
Last Update Date | 27/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114832256 | APPLE HEALTH (01) | WA |