Individual
STORMI SHILO GREMMINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
900 NE 27TH ST, BEND, OR 97701-9548
(541) 382-0479
Mailing address
3006 PUALEI CIR APT 104, HONOLULU, HI 96815-4901
(808) 282-8133
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
253021
OR
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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