Provider Demographics
NPI:1770642456
Name:SATREN, DEBRA JILL WALKER (OTRL, , CHT)
Entity Type:Individual
Prefix:
First Name:DEBRA JILL
Middle Name:WALKER
Last Name:SATREN
Suffix:
Gender:F
Credentials:OTRL, , CHT
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:WALKER
Other - Last Name:SATREN
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:OTRL, CHT
Mailing Address - Street 1:9030 N HESS ST
Mailing Address - Street 2:#225
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-9827
Mailing Address - Country:US
Mailing Address - Phone:208-818-1125
Mailing Address - Fax:
Practice Address - Street 1:8836 N HESS ST
Practice Address - Street 2:SUITE F
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-8718
Practice Address - Country:US
Practice Address - Phone:208-762-1500
Practice Address - Fax:208-762-1501
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-673225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1654524OtherNORTHERN IDAHO HAND REHAB
CAZZZ15940ZMedicare ID - Type UnspecifiedRONNING PT
ID1654524OtherNORTHERN IDAHO HAND REHAB
ID1316006182OtherNORTH IDAHO HAND REHAB
ID1654097Medicare ID - Type UnspecifiedLAKE CITY PT