Individual
STACY BETH WIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
18504 BOTHELL WAY NE, BOTHELL, WA 98011-1927
(425) 481-1933
(425) 527-6948
Mailing address
18504 BOTHELL WAY NE, BOTHELL, WA 98011-1927
(425) 481-1933
(425) 527-6948
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
407038
AZ
224Z00000X
Occupational Therapy Assistant
OC60865959
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GAB35998
—
WA
Enumeration date
09/06/2019
Last updated
11/27/2023
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