MEDICARE: TIFFANY PATTERSON OTR/L

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	225X00000X	Occupational Therapist	61144899	WA
2	225X00000X	Occupational Therapist	448862	OR
3	225X00000X	Occupational Therapist	OTH-009947	AZ

General Provider Information

NPI Number	:	1619645256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY PATTERSON OTR/L

Provider Business Mailing Address
First Line	:	14002 NE 93RD ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98682-2944
Country	:	US
Telephone Number	:	360-601-0048
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 NE GREENWOOD DRIVE STE 220
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98662-3376
Country	:	US
Telephone Number	:	602-071-5543
Fax Number	:

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

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	03/22/2025

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Directions to “ TIFFANY PATTERSON OTR/L” Practice Location

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