Organization
MUD SPOONS & SWINGS LLC
Active
Other names
Dana Yanoch
Organization subpart
No
Provider details
NPI number
Authorized official
DANA YVONNE YANOCH MOT, OTR/L (OCCUPATIONAL THERAPIST)
(503) 349-9007
Entity
Organization
Contact information
Practice address
2818 SE 75TH AVE, PORTLAND, OR 97206-1856
(503) 349-9007
(877) 239-8868
Mailing address
2818 SE 75TH AVE, PORTLAND, OR 97206-1856
(503) 349-9007
(877) 239-8868
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1054075
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962747352
NPI OF OTR
OR
Enumeration date
05/08/2013
Last updated
05/08/2013
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