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General NPI Number Information
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NPI Number | 1215272356
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Entity Type | Individual
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Provider Name | KATHERINE SHIZUE TAMURA NEELY OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 855 AARON DR
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City | LYNDEN
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State | WA
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Zip | 98264-9396
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Country | US
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Telephone | 808-224-1276
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Fax |
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Provider Business Mailing Address
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Address Line | 6878 195A STREET
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City | SURREY
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State | BRITISH COLUMBIA
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Zip | V4N5Y9
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Country | CA
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Telephone | 604-441-7399
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 60323437
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License Number State | WA
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