Provider Demographics
NPI:1043496649
Name:STINARDO, JEFF G (OTR)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:G
Last Name:STINARDO
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18514 40TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292
Mailing Address - Country:US
Mailing Address - Phone:360-652-2632
Mailing Address - Fax:360-652-2623
Practice Address - Street 1:18514 40TH AVE NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-6000
Practice Address - Country:US
Practice Address - Phone:360-652-2632
Practice Address - Fax:360-652-2623
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist