Individual
LAURA JENDUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20310 19TH AVE NE, SHORELINE, WA 98155-1261
(206) 367-5853
(206) 367-9609
Mailing address
20310 19TH AVE NE, SHORELINE, WA 98155-1261
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60204968
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60204968
WA OT LICENSE NUMBER
WA
Enumeration date
01/30/2012
Last updated
01/30/2012
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