Provider Demographics
NPI:1497172274
Name:GEREN, JOSEPH (OTR/L)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:GEREN
Suffix:
Gender:M
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 1:108 N WASHINGTON ST STE 418
Mailing Address - Street 2:SUITE 418
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-5001
Mailing Address - Country:US
Mailing Address - Phone:509-209-7429
Mailing Address - Fax:509-210-4567
Practice Address - Street 1:108 N WASHINGTON ST STE 418
Practice Address - Street 2:SUITE 418
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-5001
Practice Address - Country:US
Practice Address - Phone:509-209-7429
Practice Address - Fax:509-210-4567
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIOT60436998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA107126Medicaid
WA225100000XOtherTAXONOMY