| NPI | 1053979781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAN AYALA Credentialing COO Rdinator 425-450-9474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2020-01-13 |