Healthcare Provider Details

I. General information

NPI: 1962218388
Provider Name (Legal Business Name): HANDS-ON THERAPY AND HOME MODIFICATIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/14/2024
Certification Date: 12/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SE 168TH AVE APT 91
VANCOUVER WA
98684-8431
US

IV. Provider business mailing address

620 SE 168TH AVE APT 91
VANCOUVER WA
98684-8431
US

V. Phone/Fax

Practice location:
  • Phone: 503-781-4462
  • Fax:
Mailing address:
  • Phone: 360-836-1068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER RENEE ALLEN
Title or Position: MEMBER-MANAGER
Credential: OT
Phone: 360-836-1068