Healthcare Provider Details

I. General information

NPI: 1235377193
Provider Name (Legal Business Name): KAREN LEE SPOKANE MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LEE VASILIK MS,OTR/L CHT

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 EASTON NAZARETH HWY SUITE 202
EASTON PA
18045-8338
US

IV. Provider business mailing address

3729 EASTON NAZARETH HWY SUITE 202
EASTON PA
18045-8344
US

V. Phone/Fax

Practice location:
  • Phone: 610-258-7094
  • Fax: 610-258-6107
Mailing address:
  • Phone: 610-258-7094
  • Fax: 610-258-6107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC008767
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: