Individual
MISTY LEIGH PRUNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
710 NW JUNIPER ST, SUITE 106, ISSAQUAH, WA 98027-2717
(425) 392-2346
(425) 392-0185
Mailing address
PO BOX 819, ORTING, WA 98360-0819
(360) 893-6576
(800) 661-0688
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00003961
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8407959
—
WA
Enumeration date
09/26/2005
Last updated
07/08/2007
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