MEDICARE: AVPR PLLC

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	152WV0400X	Vision Therapy Optometrist	WA1528TX	WA
2	225XL0004X	Low Vision Occupational Therapist	OT60644519	WA
3	225XM0800X	Mental Health Occupational Therapist
4	225XN1300X	Neurorehabilitation Occupational Therapist	OT60644519	WA
5	225XP0019X	Physical Rehabilitation Occupational Therapist	OT60644519	WA
6	225XP0200X	Pediatric Occupational Therapist	OT60644519	WA
7	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1770038895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVPR PLLC

Provider Business Mailing Address
First Line	:	104 S FREYA ST.
Second Line	:	#109 D BROWN FLAG BLDG.
City	:	SPOKANE
State	:	WA
Zip	:	99202-4867
Country	:	US
Telephone Number	:	509-554-5565
Fax Number	:	509-381-3524

Provider Business Practice Location Address
First Line	:	104 S FREYA ST
Second Line	:	#109 D BROWN FLAG BLDG.
City	:	SPOKANE
State	:	WA
Zip	:	99202-4867
Country	:	US
Telephone Number	:	509-554-5565
Fax Number	:	509-381-3524

Authorized Official
Title or Position	:	OWNER/OCCUPATIONAL THERAPIST
Name	:	LAURIE JEAN MARTINCHUK
Credential	:	OTR/L
Telephone Number	:	509-554-5565

Provider Enumeration Date	:	08/18/2016
Last Update Date	:	08/29/2023

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