Provider Demographics
NPI:1487361762
Name:EDWARDS, LORAN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:LORAN
Middle Name:
Last Name:EDWARDS
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 1:1928 18TH ST APT H101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-8066
Mailing Address - Country:US
Mailing Address - Phone:253-785-1694
Mailing Address - Fax:
Practice Address - Street 1:3408 S UNION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-3140
Practice Address - Country:US
Practice Address - Phone:253-565-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist