Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 230664 | OR |
NPI | 1043449606 |
---|---|
Provider Name | Linda Demont |
First Address | Lincoln City, OR 97367-0101 |
Second Address | Newport, OR 97365-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2009 |
Last Update Date | 03/07/2009 |