Provider Demographics
NPI:1508981838
Name:ZANDER, LILA JANE (OT)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:JANE
Last Name:ZANDER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 N HARVARD RD
Mailing Address - Street 2:
Mailing Address - City:OTIS ORCHARDS
Mailing Address - State:WA
Mailing Address - Zip Code:99027-9373
Mailing Address - Country:US
Mailing Address - Phone:509-924-2805
Mailing Address - Fax:509-891-8005
Practice Address - Street 1:3808 N SULLIVAN RD
Practice Address - Street 2:BLDG. # S-7
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1608
Practice Address - Country:US
Practice Address - Phone:509-924-2850
Practice Address - Fax:509-891-8005
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004001225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7683725Medicaid