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Individual

MRS. LOUISE CHRISTINE GABRIELLE DERKSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
4206 336TH PL SE, FALL CITY, WA 98024-5103
(425) 830-8768
Mailing address
32782 NE 52ND ST, CARNATION, WA 98014-5002
(425) 445-8300

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC61191865
WA

Other

Enumeration date
02/10/2023
Last updated
02/10/2023
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