Provider Demographics
NPI:1811298227
Name:HUNTLEY, STEPHANIE (OTR)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HUNTLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1558
Mailing Address - Country:US
Mailing Address - Phone:509-466-0411
Mailing Address - Fax:
Practice Address - Street 1:16306 N CHRONICLE LN
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:WA
Practice Address - Zip Code:99005-4502
Practice Address - Country:US
Practice Address - Phone:509-238-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00003299225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist