Provider Demographics
NPI:1578880464
Name:SANDE, LAINE MARIE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:LAINE
Middle Name:MARIE
Last Name:SANDE
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 1:615 SNOW AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3851
Mailing Address - Country:US
Mailing Address - Phone:509-967-6413
Mailing Address - Fax:
Practice Address - Street 1:615 SNOW AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3851
Practice Address - Country:US
Practice Address - Phone:509-967-6413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60180241225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist