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General NPI Number Information
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NPI Number | 1326389503
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Entity Type | Individual
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Provider Name | SUSAN DALE DOYLE B.O.T., M.SC. PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 3305 MAIN ST STE 304
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City | VANCOUVER
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State | WA
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Zip | 98663-2251
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Country | US
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Telephone | 360-723-5145
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Fax | 360-282-6863
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Provider Business Mailing Address
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Address Line | 3305 MAIN ST STE 304
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City | VANCOUVER
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State | WA
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Zip | 98663-2251
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Country | US
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Telephone | 360-723-5145
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Fax | 360-282-6863
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224ZE0001X
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Taxonomy Name | Environmental Modification Occupational Therapy Assistant
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License Number | OT00001975
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 986704
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 00001975
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License Number State | WA
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