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NPI Code Detail

MEDICARE: LINDA M BOWMAN

MEDICARE: LINDA M BOWMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOC00001037WA

General Provider Information

NPI Number : 1174875272
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA M BOWMAN
Provider Business Mailing Address
First Line : 3409 204TH AVENUE CT E
Second Line :
City : LAKE TAPPS
State : WA
Zip : 98391-9031
Country : US
Telephone Number : 253-862-6600
Fax Number :
Provider Business Practice Location Address
First Line : 1320 178TH AVE E
Second Line :
City : LAKE TAPPS
State : WA
Zip : 98391-6411
Country : US
Telephone Number : 253-862-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2012
Last Update Date : 11/19/2012

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Directions to “ LINDA M BOWMAN ” Practice Location

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