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Individual
CLARENCE ANDREW SIMS
Active
Individual
CLARENCE ANDREW SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-782
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010157662
BLUE SHIELD PIN
ID
01
—
211798
WA LABOR & INDUSTRY PIN
WA
01
—
W1219
BLUE CROSS PIN
ID
Enumeration date
07/27/2006
Last updated
03/06/2009
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