Provider Demographics
NPI:1861764003
Name:SANDERS HAND THERAPY, INC
Entity type:Organization
Organization Name:SANDERS HAND THERAPY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:503-318-3927
Mailing Address - Street 1:PO BOX 1114
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-1114
Mailing Address - Country:US
Mailing Address - Phone:503-318-3927
Mailing Address - Fax:503-266-1526
Practice Address - Street 1:1914 WILLAMETTE FALLS DR STE 210
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4689
Practice Address - Country:US
Practice Address - Phone:503-266-4263
Practice Address - Fax:503-694-8366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR914221225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR165061OtherINDIVIDUAL MEDICARE PTAN
OR032297Medicaid
OR500644370Medicaid
ORR164816OtherMEDICARE BUSINESS PTAN
OR914221OtherOR OCCUPATIONAL THERAPY LICENSE
OR9611000187OtherHAND THERAPY CERTIFICATION COMMISSION
ORR165061Medicare UPIN
ORR164816OtherMEDICARE BUSINESS PTAN