Individual
DANA SOPHIA D'EAGLE
Active
Individual
DANA SOPHIA D'EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00002169
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112691
DEPT OF L&I
WA
01
—
AC7585
REGENCE B/S
WA
Enumeration date
08/24/2005
Last updated
07/03/2015
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