Provider Demographics
NPI:1487928180
Name:BOYD, BECKY ANN (OT/L, CHT)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:ANN
Last Name:BOYD
Suffix:
Gender:F
Credentials:OT/L, CHT
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/L, CHT
Mailing Address - Street 1:5322 N DIVISION ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1300
Mailing Address - Country:US
Mailing Address - Phone:509-487-1232
Mailing Address - Fax:509-489-4389
Practice Address - Street 1:5322 N DIVISION ST STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1300
Practice Address - Country:US
Practice Address - Phone:509-487-1232
Practice Address - Fax:509-489-4389
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001403225X00000X, 225XP0019X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2041364Medicaid