Provider Demographics
NPI:1154691376
Name:TESTORI, RYAN (OTR)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:TESTORI
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14217 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-1704
Mailing Address - Country:US
Mailing Address - Phone:586-530-2104
Mailing Address - Fax:
Practice Address - Street 1:14217 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-1704
Practice Address - Country:US
Practice Address - Phone:586-530-2104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 14880225X00000X
WAOT 60133993225X00000X
OR1019660225X00000X
MI5201004139225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist