Individual
MOKTAR MASANAMO BATIBURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
2102 E SPRAGUE AVE, SPOKANE, WA 99202-3125
(509) 838-4651
(509) 363-2762
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
(509) 363-2762
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CG61006256
WA
Other
Enumeration date
12/05/2017
Last updated
11/21/2019
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