Mark Owen Gardner, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT60484207 Issued in WA

Practice address

505 E 3Rd Ave Ste B
Spokane, WA 99202-1426

Phone

(509) 838-2531

Fax

(509) 755-6580

NPI assigned

Oct 17, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1225432354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E 3RD AVE STE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021426",
            "telephone_number": "509-838-2531",
            "fax_number": "509-755-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARK",
        "middle_name": "OWEN",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "60484207",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60484207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201242483WA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boden William Garda, RBT
• Anna V Gardella, MD
• Brianna Gardiner
• Elizabeth L Gardner, RPH
• Margaret Ann Gardner, LMT
• Olivia Katherine Gardner
• Shawnee Gardner, CDP, LACSW
• Timothy John Gardner, MD
• Melanie Garduno
• Tamara Garduno, MD

• Occupational Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.