Provider Demographics
NPI:1831151919
Name:DAO, TONY B (OT)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:B
Last Name:DAO
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SW INDUSTRIAL WAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1093
Mailing Address - Country:US
Mailing Address - Phone:541-585-2529
Mailing Address - Fax:541-585-2541
Practice Address - Street 1:1303 NE CUSHING DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3891
Practice Address - Country:US
Practice Address - Phone:541-382-7875
Practice Address - Fax:541-382-2181
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1031201225XH1200X
WAOT00003076225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500672339Medicaid
ORR175796Medicare PIN
WA911745305-98053-A007OtherTRICARE
WA911745305-98223-A016OtherTRICARE
WAG8896013Medicare PIN
WA0268140OtherDEPT OF L&I
911745305-98203-C004OtherTRICARE
WA911745305-98026-A016OtherTRICARE
WA8750DAOtherREGENCE BLUE SHIELD
WA0199432OtherDEPT. OF LABOR & INDUSTRY
WAP00655373OtherRAILROAD MEDICARE
WA7907DAOtherREGENCE BLUE SHIELD
WA8855209Medicare ID - Type UnspecifiedIRG IN SNOHOMISH COUNTY
WA1830DAOtherREGENCE BLUE SHIELD
WA2250DAOtherREGENCE BLUE SHIELD
WA8906747OtherL & I CRIME VICTIMS
WA7741DAOtherREGENCE
WA8855208Medicare ID - Type UnspecifiedIRG IN KING COUNTY
WA5029DAOtherREGENCE BLUE SHIELD
WA7567115OtherAETNA