Healthcare Provider Details

I. General information

NPI: 1497172274
Provider Name (Legal Business Name): JOSEPH GEREN OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N WASHINGTON ST STE 418 SUITE 418
SPOKANE WA
99201-5001
US

IV. Provider business mailing address

108 N WASHINGTON ST STE 418 SUITE 418
SPOKANE WA
99201-5001
US

V. Phone/Fax

Practice location:
  • Phone: 509-209-7429
  • Fax: 509-210-4567
Mailing address:
  • Phone: 509-209-7429
  • Fax: 509-210-4567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60436998
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: