Individual
ANITA R FAULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10020 SE 256TH ST, KENT, WA 98030-6408
(425) 254-3919
Mailing address
18205 157TH AVE SE, RENTON, WA 98058-9653
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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