Provider Demographics
NPI:1639756265
Name:HAMUSEK, AMBER (COTA/L)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HAMUSEK
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 SE CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1231
Mailing Address - Country:US
Mailing Address - Phone:949-230-0264
Mailing Address - Fax:
Practice Address - Street 1:801 SE PARK CREST AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-1300
Practice Address - Country:US
Practice Address - Phone:360-260-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant