Healthcare Provider Details

I. General information

NPI: 1649453697
Provider Name (Legal Business Name): CINDY JO DEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SUNNYVIEW LN
KALISPELL MT
59901-3129
US

IV. Provider business mailing address

400 VETERANS DRIVE P.O. BOX 250
COLUMBIA FALLS MT
59912-0250
US

V. Phone/Fax

Practice location:
  • Phone: 406-751-4189
  • Fax:
Mailing address:
  • Phone: 406-892-3256
  • Fax: 406-892-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number769
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00009640
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT00001701
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1518
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: