Audrey Mae Lande, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA-102 Issued in ID

Practice address

331 E Park St
Weiser, ID 83672-2053

Phone

(208) 549-2416

Fax

(208) 549-0536

NPI assigned

Jun 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1457511081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 CASA RIO DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979148559",
            "telephone_number": "541-889-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E PARK ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722053",
            "telephone_number": "208-549-2416",
            "fax_number": "208-549-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDE",
        "first_name": "AUDREY",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ID",
            "license": "OTA-102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Therapeutic Services
• Steven G Iwasa, O.D.
• Tyler Jue, NP
• Kindred Nursing Centers West, LLC
• Michael Lafferty, PTA
• Evan W. Lee Jr., D.O.
• Kayla Lo, FNP-C
• Karen Rene Lockwood, COTA/L
• Christopher Earl Malloy, DMD
• Vanyssa Marble, B.S.

• Occupational Therapy Assistant in Weiser, ID
• Providers in Weiser, ID by specialty
• Occupational Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.