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Individual

JARED R RATTRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR L, CHT

Contact information

Practice address
1205 HIGHWAY 2 STE 102, SANDPOINT, ID 83864-2740
(800) 353-5208
(866) 365-5203
Mailing address
PO BOX 11009, OLYMPIA, WA 98508-1009
(509) 962-1132
(866) 365-5203

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
OT00003293
WA
225X00000X
Occupational Therapist
Primary
OT-2073
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
174764
LABOR & INDUSTRIES
WA
01
1770651390
NPI NUMBER
05
7682594
WA
01
9730RA
REGENCE NUMBER
01
DA9136
MEDICARE RAILROAD
Enumeration date
12/01/2006
Last updated
10/14/2021
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