Individual
MS. VICTORIA LYNN MACKINDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
8011 112TH STREET CT E, PUYALLUP, WA 98373-7814
(253) 848-0662
(253) 848-8567
Mailing address
9315 GRAVELLY LAKE DR SW, SUITE 306, LAKEWOOD, WA 98499-1574
(253) 581-5200
(253) 581-5203
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60341665
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0307022
L&I PROVIDER ID
WA
Enumeration date
03/15/2013
Last updated
09/19/2013
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