Provider Demographics
NPI:1437587128
Name:MOORE, EMILY (COTA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:COTA
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 48070
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99228-1070
Mailing Address - Country:US
Mailing Address - Phone:509-487-2958
Mailing Address - Fax:
Practice Address - Street 1:8502 N NEVADA ST STE 2
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-7395
Practice Address - Country:US
Practice Address - Phone:509-487-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant