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General NPI Number Information
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NPI Number | 1073530770
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Entity Type | Individual
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Provider Name | BROOKE EYTCHISON OT
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 2800 NORTHUP WAY # 260
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City | BELLEVUE
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State | WA
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Zip | 98004-1440
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Country | US
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Telephone | 425-827-5877
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Fax |
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Provider Business Mailing Address
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Address Line | 1519 132ND ST SE SUITE A
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City | EVERETT
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State | WA
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Zip | 98208-7203
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Country | US
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Telephone | 425-827-5877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OT 00003909
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT00003909
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License Number State | WA
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