Provider Demographics
NPI:1740531680
Name:SMITH, JASON ALLEN (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ALLEN
Last Name:SMITH
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 EAST BELLEVIEW AVENUE
Mailing Address - Street 2:SUITE #615
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2898
Mailing Address - Country:US
Mailing Address - Phone:303-694-3333
Mailing Address - Fax:303-694-9666
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:SUITE #615
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-694-3333
Practice Address - Fax:303-694-9666
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3290225XH1200X
UT13444720-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand