Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT00000545 | WA |
N | 225XH1200X | Occupational Therapist - Hand |
NPI | 1114965001 |
---|---|
Provider Name | Tracy E. Springman |
First Address | Edmonds, WA 98026-8006 |
Second Address | Mill Creek, WA 98012-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 17/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0285975 | L & I (01) | WA |