Organization
EASTSIDE HAND REHABILITATION CLINIC INC
Active
Organization
EASTSIDE HAND REHABILITATION CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNNLEE FULLENWIDER OTRL CHT (OWNER PRESIDENT)
(425) 823-1389
Entity
Organization
Contact information
Practice address
12911-120TH AVE NE, SUITE F-120, KIRKLAND, WA 98034-3025
(425) 823-1389
(425) 820-3996
Mailing address
12911-120TH AVE NE, SUITE F-120, KIRKLAND, WA 98034-3025
(425) 823-1389
(425) 820-3996
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XH1200X
Hand Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34460
L & I
WA
05
—
7680697
—
WA
01
—
EA2218
REGENCE
WA
01
—
T06695
PREMERA
WA
Enumeration date
03/07/2007
Last updated
12/09/2009
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