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Individual

DIANE M NEWMAN-BRANCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 830-1100
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT00001152
WA
225XH1200X
Hand Occupational Therapist
Primary
OT00001152
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
198209
LABOR & INDUSTRIES
WA
05
8351520
WA
01
8906174
CRIME VICTIMS COMP
WA
01
8918NE
REGENCE BLUESHIELD
01
P00391583
RAILROAD MEDICARE
Enumeration date
06/12/2006
Last updated
03/08/2018
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