Provider Demographics
NPI:1942520556
Name:WILLAMETTE HAND THERAPY, LLC
Entity Type:Organization
Organization Name:WILLAMETTE HAND THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:AHEARN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, OTR/L, CHT
Authorized Official - Phone:541-359-4536
Mailing Address - Street 1:1711 WILLAMETTE ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4014
Mailing Address - Country:US
Mailing Address - Phone:541-357-4536
Mailing Address - Fax:541-653-9669
Practice Address - Street 1:1711 WILLAMETTE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4014
Practice Address - Country:US
Practice Address - Phone:541-357-4536
Practice Address - Fax:541-659-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR=========OtherTAX ID