Provider Demographics
NPI:1477745651
Name:HAND THERAPY INCORPORATED
Entity Type:Organization
Organization Name:HAND THERAPY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT HAND THERAPY INC
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:POULOS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L CNT
Authorized Official - Phone:360-676-4263
Mailing Address - Street 1:PO BOX 1557
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-1557
Mailing Address - Country:US
Mailing Address - Phone:360-647-7681
Mailing Address - Fax:360-671-3366
Practice Address - Street 1:1611 BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3039
Practice Address - Country:US
Practice Address - Phone:360-647-7681
Practice Address - Fax:360-671-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB26863Medicare PIN