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1164405742

NPI Code Detail

MEDICARE: KATHERINE A STEVENS OTR

MEDICARE: KATHERINE A STEVENS OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist	1031476	OR
2	225XH1200X	Hand Occupational Therapist	OT00003250	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130651	OTHER	WA	WA L&I
2	098565014	OTHER	OR	BCBSO
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164405742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE A STEVENS OTR

Provider Business Mailing Address
First Line	:	2330 NW FLANDERS ST
Second Line	:	STE G-1
City	:	PORTLAND
State	:	OR
Zip	:	97210-3442
Country	:	US
Telephone Number	:	503-224-9270
Fax Number	:	503-224-9271

Provider Business Practice Location Address
First Line	:	2330 NW FLANDERS ST
Second Line	:	STE G-1
City	:	PORTLAND
State	:	OR
Zip	:	97210-3442
Country	:	US
Telephone Number	:	503-224-9270
Fax Number	:	503-224-9271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	01/16/2015

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Directions to “ KATHERINE A STEVENS OTR” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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