Individual
BETH WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7618 FAIR OAKS RD SE, OLYMPIA, WA 98513-6421
(360) 493-2006
Mailing address
PO BOX 15196, TUMWATER, WA 98511-5196
(360) 493-2006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00000616
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1045795
—
WA
05
—
7681570
—
WA
Enumeration date
11/15/2005
Last updated
05/25/2017
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