Provider Demographics
NPI:1568200145
Name:MOHTES-CHAN, LEAH (PT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MOHTES-CHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 E 34TH LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6034
Mailing Address - Country:US
Mailing Address - Phone:530-848-3897
Mailing Address - Fax:
Practice Address - Street 1:4408 E 34TH LN
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-6034
Practice Address - Country:US
Practice Address - Phone:530-848-3897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA608668982251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics