Provider Demographics
NPI:1750089561
Name:OJA, AVERY L (DPT)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:L
Last Name:OJA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E WESTVIEW CT STE A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1376
Mailing Address - Country:US
Mailing Address - Phone:509-465-1749
Mailing Address - Fax:
Practice Address - Street 1:10258 W HIGHWAY 2 STE 4
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-5459
Practice Address - Country:US
Practice Address - Phone:509-244-9968
Practice Address - Fax:509-244-9914
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61358908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist