Individual
JEANNETTE WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
20310 19TH AVE NE, SHORELINE, WA 98155-1261
(206) 367-5853
Mailing address
4034 41ST AVE SW, SEATTLE, WA 98116-3818
(206) 367-5853
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00002288
WA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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