Provider Demographics
NPI:1093247942
Name:TERAO-ROBIDOUX, LEILANI (COTA)
Entity Type:Individual
Prefix:
First Name:LEILANI
Middle Name:
Last Name:TERAO-ROBIDOUX
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:AIKO
Other - Middle Name:
Other - Last Name:TERAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19307 E CATALDO AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-9489
Mailing Address - Country:US
Mailing Address - Phone:509-228-5500
Mailing Address - Fax:
Practice Address - Street 1:19307 E CATALDO AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99016-9489
Practice Address - Country:US
Practice Address - Phone:509-228-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60725690224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant