Provider Demographics
NPI:1316290315
Name:JOHNSON, CHERI JO (MED, OTL)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:JO
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MED, OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19307 E. CATALDO
Mailing Address - Street 2:CENTRAL VALLEY SCHOOL DISTRICT SPECIAL SERVICES
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016
Mailing Address - Country:US
Mailing Address - Phone:509-223-5513
Mailing Address - Fax:
Practice Address - Street 1:10304 E 9TH AVE
Practice Address - Street 2:EARLY LEARNING CENTER
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3574
Practice Address - Country:US
Practice Address - Phone:509-228-5513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001122225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics