Healthcare Provider Details

I. General information

NPI: 1801342977
Provider Name (Legal Business Name): BRYCE HOBSON OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 N POTOMAC RIVER LN
SPOKANE VALLEY WA
99016-9495
US

IV. Provider business mailing address

1607 N POTOMAC RIVER LN
SPOKANE VALLEY WA
99016-9495
US

V. Phone/Fax

Practice location:
  • Phone: 509-499-0636
  • Fax:
Mailing address:
  • Phone: 509-499-0636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 60686370
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: