Provider Demographics
NPI:1215217336
Name:LIEN, SANDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LIEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:LIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3606 AUTUMNWOOD CT SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6605
Mailing Address - Country:US
Mailing Address - Phone:360-491-2171
Mailing Address - Fax:
Practice Address - Street 1:4780 CAPITOL BLVD SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4493
Practice Address - Country:US
Practice Address - Phone:360-491-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000314225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist