MEDICARE: KIRSTEN H HATTON OTR/L

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
1	225XP0200X	Pediatric Occupational Therapist	OT00004412	WA

General Provider Information

NPI Number	:	1386777993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN H HATTON OTR/L

Provider Business Mailing Address
First Line	:	314 W SHANNON AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-4744
Country	:	US
Telephone Number	:	509-389-3078
Fax Number	:

Provider Business Practice Location Address
First Line	:	9827 N NEVADA ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-3407
Country	:	US
Telephone Number	:	509-468-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	01/30/2009

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