Provider Demographics
NPI:1174169882
Name:HARE, LAURIE CINTRA (OTR/L)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:CINTRA
Last Name:HARE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10414 SW 238TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7656
Mailing Address - Country:US
Mailing Address - Phone:206-463-3019
Mailing Address - Fax:
Practice Address - Street 1:10414 SW 238TH ST
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-7656
Practice Address - Country:US
Practice Address - Phone:206-463-3019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA278010001200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist