Provider Demographics
NPI:1376704593
Name:MACDONALD, JOSHUA LUKE (MSOTR/L)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:LUKE
Last Name:MACDONALD
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Gender:M
Credentials:MSOTR/L
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Mailing Address - Street 1:9980 W GLENDALE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85307-3005
Mailing Address - Country:US
Mailing Address - Phone:623-226-8804
Mailing Address - Fax:602-532-7839
Practice Address - Street 1:9980 W GLENDALE AVE STE 110
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-3005
Practice Address - Country:US
Practice Address - Phone:623-226-8804
Practice Address - Fax:602-532-7839
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2782225XP0200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics