Provider Demographics
NPI:1285051060
Name:CAMP, SHELLEY LOIS (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:LOIS
Last Name:CAMP
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:LOIS
Other - Last Name:SCOFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:1515 E 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-4129
Mailing Address - Country:US
Mailing Address - Phone:509-951-2052
Mailing Address - Fax:590-747-7006
Practice Address - Street 1:1515 E 39TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-4129
Practice Address - Country:US
Practice Address - Phone:509-951-2052
Practice Address - Fax:590-747-7006
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001793225X00000X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist