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NPI Code Detail

MEDICARE: EMMA BRAKS OT

MEDICARE:   EMMA  BRAKS  OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1245913839
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA BRAKS OT
Provider Business Mailing Address
First Line : 22 W 28TH AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99203-1858
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7710 NE GREENWOOD DR STE 220
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-7904
Country : US
Telephone Number : 360-207-1554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2023
Last Update Date : 08/09/2023

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Directions to “ EMMA BRAKS OT” Practice Location

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