Provider Demographics
NPI:1306014873
Name:SHORS, CHELSEA J (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:J
Last Name:SHORS
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 1:380 NW TERRE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-3689
Mailing Address - Country:US
Mailing Address - Phone:904-553-5852
Mailing Address - Fax:
Practice Address - Street 1:1310 NW DEANE ST
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-3705
Practice Address - Country:US
Practice Address - Phone:904-553-5852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11817225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist