Provider Demographics
NPI:1093932154
Name:GUNDERSON, TRISHA J (OTD, OTR-L)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:J
Last Name:GUNDERSON
Suffix:
Gender:F
Credentials:OTD, OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:COLUMBUS COMMUNITY HOSPITAL
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1800
Mailing Address - Country:US
Mailing Address - Phone:402-562-3341
Mailing Address - Fax:402-564-0730
Practice Address - Street 1:4600 38TH ST
Practice Address - Street 2:COLUMBUS COMMUNITY HOSPITAL
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1664
Practice Address - Country:US
Practice Address - Phone:402-562-3341
Practice Address - Fax:402-564-0730
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist