Individual
MARK OWEN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
505 E 3RD AVE STE B, SPOKANE, WA 99202-1426
(509) 838-2531
(509) 755-6580
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60484207
WA
225XH1200X
Hand Occupational Therapist
60484207
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201242483WA
—
WA
Enumeration date
10/17/2014
Last updated
11/07/2014
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