Provider Demographics
NPI:1780903500
Name:MYERS, LYDIA ELLEN (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:ELLEN
Last Name:MYERS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:ELLEN
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:3731 S SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2736
Mailing Address - Country:US
Mailing Address - Phone:509-879-2463
Mailing Address - Fax:509-443-3061
Practice Address - Street 1:3731 S SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2736
Practice Address - Country:US
Practice Address - Phone:509-879-2463
Practice Address - Fax:509-443-3061
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60134753225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology