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NPI Code Detail

MEDICARE: CHELSEA J SHORS OTD, OTR/L

MEDICARE: CHELSEA J SHORS OTD, OTR/L
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
1225X00000XOccupational TherapistOT11817FL

General Provider Information

NPI Number : 1306014873
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA J SHORS OTD, OTR/L
Provider Business Mailing Address
First Line : 380 NW TERRE VIEW DR
Second Line :
City : PULLMAN
State : WA
Zip : 99163-3689
Country : US
Telephone Number : 904-553-5852
Fax Number :
Provider Business Practice Location Address
First Line : 1310 NW DEANE ST
Second Line :
City : PULLMAN
State : WA
Zip : 99163-3705
Country : US
Telephone Number : 904-553-5852
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2008
Last Update Date : 03/14/2012

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