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Individual

TAMI MARIE WALTERS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
3615 SPICER DR SE, ALBANY, OR 97322-7043
(541) 967-7551
(541) 967-5095
Mailing address
3615 SPICER DR SE, ALBANY, OR 97322-7043
(541) 967-7551
(541) 967-5095

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2261
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158796
OR
01
A004
TRICARE ID#
OR
01
B060404
PACIFICSOURCE ID#
OR
Enumeration date
05/15/2006
Last updated
07/09/2007
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