Provider Demographics
NPI:1386634640
Name:MANN, DONNA (OTR L)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:MANN
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 1:2009 E SMYTHE RD
Mailing Address - Street 2:
Mailing Address - City:SPANGLE
Mailing Address - State:WA
Mailing Address - Zip Code:99031-9528
Mailing Address - Country:US
Mailing Address - Phone:509-991-7825
Mailing Address - Fax:
Practice Address - Street 1:300 W HAWTHORNE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99251-2705
Practice Address - Country:US
Practice Address - Phone:509-777-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000447225XE0001X, 225XE1200X, 225XH1200X, 225XP0019X, 225XP0200X
WAOT 00000447225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8341281Medicaid
WA8341281Medicaid