Provider Demographics
NPI:1740048289
Name:MESSMER, LANI ELYSE (OTR/L)
Entity type:Individual
Prefix:
First Name:LANI
Middle Name:ELYSE
Last Name:MESSMER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LANI
Other - Middle Name:ELYSE
Other - Last Name:LAURILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:WAUNA
Mailing Address - State:WA
Mailing Address - Zip Code:98395-0934
Mailing Address - Country:US
Mailing Address - Phone:626-375-4820
Mailing Address - Fax:
Practice Address - Street 1:5215 CORPORATE CENTER CT SE STE D
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5800
Practice Address - Country:US
Practice Address - Phone:360-445-8155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61534157225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist