Individual
CARL ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
6004 WESTGATE BLVD, STE 220, TACOMA, WA 98406-2503
(253) 759-4065
Mailing address
440 ELMCROFT BLVD APT 3214, ROCKVILLE, MD 20850-5642
(914) 319-8014
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
06200
MD
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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