Provider Demographics
NPI:1497197933
Name:MIDDAUGH, CRAIG FRANKLIN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:FRANKLIN
Last Name:MIDDAUGH
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:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:CHATTAROY
Mailing Address - State:WA
Mailing Address - Zip Code:99003-0172
Mailing Address - Country:US
Mailing Address - Phone:509-499-8615
Mailing Address - Fax:
Practice Address - Street 1:1225 N ARGONNE RD STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2798
Practice Address - Country:US
Practice Address - Phone:509-505-5315
Practice Address - Fax:509-530-2837
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OT603668800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist