Individual
SUSAN BROADHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4515 MARTIN LUTHER KING JR WAY S, SUITE 100, SEATTLE, WA 98108-2182
(206) 325-5325
(206) 325-5326
Mailing address
4515 MARTIN LUTHER KING JR WAY S, SUITE 100, SEATTLE, WA 98108-2182
(206) 325-5325
(206) 325-5326
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
984994
OR
225X00000X
Occupational Therapist
Primary
OT0001772
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
984994
OREGON DEPARTMENT OF HEALTH
OR
01
—
OT00001772
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
02/03/2010
Last updated
02/03/2010
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