Provider Demographics
NPI:1306176292
Name:'OHANA OCCUPATIONAL THERAPY,LLC
Entity type:Organization
Organization Name:'OHANA OCCUPATIONAL THERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:KOSTKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-699-0214
Mailing Address - Street 1:8855 MOUNTAIN HOME RD
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-9392
Mailing Address - Country:US
Mailing Address - Phone:509-699-0214
Mailing Address - Fax:
Practice Address - Street 1:8855 MOUNTAIN HOME RD
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:WA
Practice Address - Zip Code:98826-9392
Practice Address - Country:US
Practice Address - Phone:509-699-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty