Provider Demographics
NPI:1760733638
Name:KNIGHT, BONNIE LEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:LEE
Last Name:KNIGHT
Suffix:
Gender:F
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 1:4420 E RED ROAN DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-9733
Mailing Address - Country:US
Mailing Address - Phone:509-768-4354
Mailing Address - Fax:
Practice Address - Street 1:4420 E RED ROAN DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-9733
Practice Address - Country:US
Practice Address - Phone:509-768-4354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00004513225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics