Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 60922661 | WA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 60922661 | WA |
NPI | 1578129136 |
---|---|
Provider Name | Yoko Louise Criner |
First Address | Redmond, WA 98052-9410 |
Second Address | Monroe, WA 98272-1108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2019 |
Last Update Date | 18/05/2019 |