Provider Demographics
NPI:1366899882
Name:BREWER, LYNDSAY (OTR/L)
Entity type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 BURCH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-9643
Mailing Address - Country:US
Mailing Address - Phone:425-221-8717
Mailing Address - Fax:
Practice Address - Street 1:3933 BURCH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-9643
Practice Address - Country:US
Practice Address - Phone:425-221-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60635541225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist