Individual
JOHN PAUL LIWANAG MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
2715 LILAC ST, LONGVIEW, WA 98632-3526
(360) 575-7019
Mailing address
35899 ESPERIA WAY, FALLBROOK, CA 92028-6535
(559) 707-0670
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
22577
CA
225X00000X
Occupational Therapist
455860
OR
225X00000X
Occupational Therapist
Primary
OT61664045
WA
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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