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General NPI Number Information
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NPI Number | 1407191844
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Entity Type | Individual
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Provider Name | JULIE VANANTWERP OT/L
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Gender | Female
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 216 E 4TH ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3200
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Country | US
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Telephone | 360-357-8575
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3183
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City | PORT ANGELES
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State | WA
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Zip | 98362-0341
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Country | US
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Telephone | 616-403-6632
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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 | OT 60108298
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License Number State | WA
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