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General NPI Number Information
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NPI Number | 1508934274
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Entity Type | Individual
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Provider Name | SHAUNA DENISE BURCHETT OTRL
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1605 W GARLAND AVE
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City | SPOKANE
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State | WA
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Zip | 99205-2620
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Country | US
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Telephone | 509-444-8383
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Fax | 509-444-8385
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Provider Business Mailing Address
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Address Line | 4820 N BEMIS ST
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City | SPOKANE
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State | WA
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Zip | 99205
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Country | US
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Telephone |
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Fax |
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | OT00002144
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License Number State | WA
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