Provider Demographics
NPI:1770618431
Name:HUBER, PATRICIA LYNN BUNGE (OT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN BUNGE
Last Name:HUBER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:BUNGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15302 40TH AVE W
Mailing Address - Street 2:UNIT 1-202
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087
Mailing Address - Country:US
Mailing Address - Phone:808-227-4899
Mailing Address - Fax:
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-983-6742
Practice Address - Fax:808-983-6752
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X
HI660225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics