# MUD SPOONS & SWINGS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dana Yanoch
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114362712
- **Authorized official:** DANA YVONNE YANOCH MOT, OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (503) 349-9007

## Contact information

- **Practice address:** 2818 SE 75TH AVE, PORTLAND, OR 97206-1856
- **Practice address phone:** (503) 349-9007
- **Practice address fax:** (877) 239-8868
- **Mailing address:** 2818 SE 75TH AVE, PORTLAND, OR 97206-1856
- **Mailing address phone:** (503) 349-9007
- **Mailing address fax:** (877) 239-8868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 1054075 | OR | Yes |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 05/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1962747352 | NPI OF OTR | OR |