Provider Demographics
NPI:1831302413
Name:DESCHENES HAND REHABILITATION SERVICES
Entity Type:Organization
Organization Name:DESCHENES HAND REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DESCHENES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L, CHT
Authorized Official - Phone:425-355-3677
Mailing Address - Street 1:6320 EVERGREEN WAY
Mailing Address - Street 2:SUITE 206A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-4500
Mailing Address - Country:US
Mailing Address - Phone:425-355-3677
Mailing Address - Fax:
Practice Address - Street 1:6320 EVERGREEN WAY
Practice Address - Street 2:SUITE 206A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4500
Practice Address - Country:US
Practice Address - Phone:425-355-3677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001264225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA72843OtherLABOR & INDUSTRIES
WA7680465Medicaid
WAR10001OtherREGENCE BLUE SHIELD