Provider Demographics
NPI:1437679099
Name:HANSEN, EMILY A (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:A
Last Name:HANSEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:A
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1202 WOOD AVENUE
Mailing Address - Street 2:SUMNER SCHOOL DISTRICT
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390
Mailing Address - Country:US
Mailing Address - Phone:253-891-6000
Mailing Address - Fax:
Practice Address - Street 1:12202 209TH AVE CT. E.
Practice Address - Street 2:LIBERTY RIDGE ELEMENTARY SCHOOL
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391
Practice Address - Country:US
Practice Address - Phone:253-891-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60003452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist