Provider Demographics
NPI:1497127153
Name:SPEHAR, ANDEE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:ANDEE
Middle Name:
Last Name:SPEHAR
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 CONVERSE AVE SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7808
Mailing Address - Country:US
Mailing Address - Phone:360-443-2719
Mailing Address - Fax:
Practice Address - Street 1:2689 HOOVER AVE SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3013
Practice Address - Country:US
Practice Address - Phone:360-443-2719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60305089225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics