| Forrest Dean Hammeren, | |
|
2438 Mountain View Dr, Emmett, ID 83617-9581 | |
| (208) 475-1984 | |
| (208) 463-0901 |
| Full Name | Forrest Dean Hammeren |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 2438 Mountain View Dr, Emmett, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063756443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT-688 (Idaho) | Primary |
| 225X00000X | Occupational Therapist | 1068103 (Oregon) | Secondary |
| Provider Name | Delta Physical Therapy And Sports Medicine Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1801834700 PECOS PAC ID: 0941101372 Enrollment ID: O20040117000230 |
| Provider Name | Mountain Land Rehabilitation Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1265549372 PECOS PAC ID: 9234048745 Enrollment ID: O20220401002028 |
| Mailing Address | Practice Location Address |
|---|---|
| Forrest Dean Hammeren, 2438 Mountain View Dr, Emmett, ID 83617-9581 Ph: () - | Forrest Dean Hammeren, 2438 Mountain View Dr, Emmett, ID 83617-9581 Ph: (208) 475-1984 |
Mrs. Lori Kay Warner, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3765 Van Dussen Rd, Emmett, ID 83617 Phone: 208-365-4768 | |
Sabrina Field, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 912 S Washington Ave, Emmett, ID 83617 Phone: 208-365-4400 |