Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XL0004X | Low Vision | OT60644519 | WA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT60644519 | WA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT60644519 | WA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT60644519 | WA |
NPI | 1831644079 |
---|---|
Provider Name | Laurie Martinchuk |
First Address | Spokane, WA 99203-2556 |
Second Address | Spokane, WA 99203-2556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2016 |
Last Update Date | 17/08/2016 |