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NPI 1770884975

NPI 1770884975 : YAHTIL WEST OTR/L : BLAINE, WA

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General NPI Number Information
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    NPI Number           |    1770884975
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    Entity Type          |    Individual 
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    Provider Name        |    YAHTIL WEST OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/04/2010
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    Last Update Date     |    11/04/2010
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Provider Practice Location Address
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    Address Line         |    7989 BLAINE RD 
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    City                 |    BLAINE
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    State                |    WA
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    Zip                  |    98230-9131
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    Country              |    US
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    Telephone            |    360-393-6857
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7989 BLAINE RD 
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    City                 |    BLAINE
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    State                |    WA
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    Zip                  |    98230-9131
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    Country              |    US
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    Telephone            |    360-393-6857
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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       |    OT60110445
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    License Number State |    WA
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