Provider Demographics
NPI:1295030849
Name:STRUCK, BARBARA KAREN (OTR/L)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:KAREN
Last Name:STRUCK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:KAREN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:47 FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2515
Mailing Address - Country:US
Mailing Address - Phone:509-301-1753
Mailing Address - Fax:
Practice Address - Street 1:1025 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4116
Practice Address - Country:US
Practice Address - Phone:509-897-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000973225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation