Provider Demographics
NPI:1215183017
Name:WOOD, SANDRA LYNN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LYNN
Last Name:WOOD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:LYNN
Other - Last Name:ROPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4560 SE INTERNATIONAL WAY, SUITE 100
Mailing Address - Street 2:CONSONUS HEALTHCARE SERVICES
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222
Mailing Address - Country:US
Mailing Address - Phone:971-206-5200
Mailing Address - Fax:971-206-5209
Practice Address - Street 1:4560 SE INTERNATIONAL WAY, SUITE 100
Practice Address - Street 2:CONSONUS HEALTHCARE SERVICES
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222
Practice Address - Country:US
Practice Address - Phone:971-206-5200
Practice Address - Fax:971-206-5209
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC00000561224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant