Provider Demographics
NPI:1306139779
Name:STRANBERG, KARL KURT JR (OT)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:KURT
Last Name:STRANBERG
Suffix:JR
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:4631 WHITMAN LN SE
Practice Address - Street 2:STE D
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98513-2250
Practice Address - Country:US
Practice Address - Phone:360-455-8155
Practice Address - Fax:360-455-1655
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60225670225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0279551OtherL & I
WA0279551OtherL & I