Provider Demographics
NPI:1356414981
Name:VANHOUTEN, ROBIN ELIZABETH BRADBURY (OTR/L)
Entity type:Individual
Prefix:
First Name:ROBIN ELIZABETH
Middle Name:BRADBURY
Last Name:VANHOUTEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:ELIZABETH
Other - Last Name:BRADBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:509 S SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4918
Mailing Address - Country:US
Mailing Address - Phone:208-755-8511
Mailing Address - Fax:999-999-9999
Practice Address - Street 1:1013 E COEUR DALENE AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4121
Practice Address - Country:US
Practice Address - Phone:208-755-8511
Practice Address - Fax:999-999-9999
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004340225X00000X
IDOT-746225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics