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General NPI Number Information
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NPI Number | 1659461341
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Entity Type | Organization
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Legal Business Name | HAND THERAPY SPECIALIST, LLC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 3621 ENSIGN RD NE STE B
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City | OLYMPIA
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State | WA
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Zip | 98506-5024
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Country | US
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Telephone | 360-923-5840
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Fax | 360-459-4836
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Provider Business Mailing Address
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Address Line | 3621 ENSIGN RD NE STE B
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City | OLYMPIA
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State | WA
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Zip | 98506-5024
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Country | US
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Telephone | 360-923-5840
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Fax | 360-459-4836
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL C MENDIOLA
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Credential | OTR/L, CHT
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Telephone | 360-923-5840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT00003444
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT00000867
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License Number State | WA
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