Healthcare Provider Details

I. General information

NPI: 1770038895
Provider Name (Legal Business Name): AVPR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 08/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S FREYA ST #109 D BROWN FLAG BLDG.
SPOKANE WA
99202-4867
US

IV. Provider business mailing address

104 S FREYA ST. #109 D BROWN FLAG BLDG.
SPOKANE WA
99202-4867
US

V. Phone/Fax

Practice location:
  • Phone: 509-554-5565
  • Fax: 509-381-3524
Mailing address:
  • Phone: 509-554-5565
  • Fax: 509-381-3524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberWA1528TX
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License NumberOT60644519
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT60644519
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT60644519
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT60644519
License Number StateWA
# 7
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAURIE JEAN MARTINCHUK
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 509-554-5565