Healthcare Provider Details

I. General information

NPI: 1366649519
Provider Name (Legal Business Name): ANNETTE MORGAN ROMESBURG OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 04/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8502 N NEVADA ST #2
SPOKANE WA
99208-7395
US

IV. Provider business mailing address

6928 S CREST VIEW ST
SPOKANE WA
99224-7419
US

V. Phone/Fax

Practice location:
  • Phone: 509-487-2958
  • Fax: 509-487-3025
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT00003161
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: