Basic Information
| Provider Information | |||||||||
| NPI: | 1942699301 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAP | ||||||||
| FirstName: | SUNSHINE | ||||||||
| MiddleName: | LUZANO | ||||||||
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| Credential: | COTA/L | ||||||||
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| OtherLastName: | LUZANO | ||||||||
| OtherFirstName: | SUNSHINE | ||||||||
| OtherMiddleName: | PO | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4560 SE INTERNATIONAL WAY | ||||||||
| Address2: | STE. 100 | ||||||||
| City: | MILWAUKIE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9712065200 | ||||||||
| FaxNumber: | 9712065203 | ||||||||
| Practice Location | |||||||||
| Address1: | 23600 MARINE VIEW DR. S. | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068244000 | ||||||||
| FaxNumber: | 9712065203 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2015 | ||||||||
| LastUpdateDate: | 01/22/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OC60486718 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.