Provider Demographics
NPI:1457819427
Name:TASHJIAN, HANNAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:TASHJIAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 S KNIK GOOSE BAY RD STE E
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8090
Mailing Address - Country:US
Mailing Address - Phone:907-317-5895
Mailing Address - Fax:
Practice Address - Street 1:613 S KNIK GOOSE BAY RD STE E
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8090
Practice Address - Country:US
Practice Address - Phone:907-317-5895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK143721225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics