Individual
SUSAN JANKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 433-2125
Mailing address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 433-2125
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT00001458
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT00001458
OCCUPATIONAL THERAPY LICENSE
WA
Enumeration date
10/30/2012
Last updated
10/30/2012
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