Provider Demographics
NPI:1023120839
Name:LANCE, PHILIPPA D (OTR/L)
Entity type:Individual
Prefix:
First Name:PHILIPPA
Middle Name:D
Last Name:LANCE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:PHILIPPA
Other - Middle Name:D
Other - Last Name:KRAUSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1637 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-7622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1637 GRANT ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-7622
Practice Address - Country:US
Practice Address - Phone:360-379-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002732225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist