Provider Demographics
NPI:1518050996
Name:STEARNS, FLINT ANTHONY (OTRL ATP CWCE)
Entity Type:Individual
Prefix:
First Name:FLINT
Middle Name:ANTHONY
Last Name:STEARNS
Suffix:
Gender:M
Credentials:OTRL ATP CWCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 POCAHONTAS RD
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814
Mailing Address - Country:US
Mailing Address - Phone:541-523-8130
Mailing Address - Fax:541-523-1793
Practice Address - Street 1:3325 POCAHONTAS RD
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814
Practice Address - Country:US
Practice Address - Phone:541-523-8130
Practice Address - Fax:541-523-1793
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1024201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1024201OtherOT LICENSING BOARD