Provider Demographics
NPI:1053580480
Name:LEHNER, MARK TODD (OT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:TODD
Last Name:LEHNER
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 33RD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2776
Mailing Address - Country:US
Mailing Address - Phone:360-759-7500
Mailing Address - Fax:360-759-1515
Practice Address - Street 1:100 E 33RD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2776
Practice Address - Country:US
Practice Address - Phone:360-759-7500
Practice Address - Fax:360-759-1515
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001847225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist