Organization
PNW HOME FOR LIFE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE COLLEEN WYATT OTR/L (OCCUPATIONAL THERAPIST)
(360) 770-1752
Entity
Organization
Contact information
Practice address
4815 SHARPE RD, ANACORTES, WA 98221-8403
(360) 770-1752
Mailing address
4815 SHARPE RD, ANACORTES, WA 98221-8403
(360) 770-1752
Taxonomy
Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
Primary
—
—
Other
Enumeration date
01/18/2020
Last updated
01/18/2020
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