Provider Demographics
NPI:1881237790
Name:JAMES, SANDRA ELIZABETH (OTR/L)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:JAMES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 N NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-3537
Mailing Address - Country:US
Mailing Address - Phone:360-405-5836
Mailing Address - Fax:360-782-5093
Practice Address - Street 1:105 N NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-3537
Practice Address - Country:US
Practice Address - Phone:360-405-5836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60682035224Z00000X
WA61479594225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant