MEDICARE: MS. TERESA LYNN SKINNER OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	00002217	WA

General Provider Information

NPI Number	:	1225377872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA LYNN SKINNER OT

Provider Business Mailing Address
First Line	:	3407 W 7TH AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99224-1905
Country	:	US
Telephone Number	:	509-999-6466
Fax Number	:	509-747-4024

Provider Business Practice Location Address
First Line	:	3407 W 7TH AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99224-1905
Country	:	US
Telephone Number	:	509-999-6466
Fax Number	:	509-747-4024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2013
Last Update Date	:	02/01/2013

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