Healthcare Provider Details

I. General information

NPI: 1891830188
Provider Name (Legal Business Name): BHARATI U PAWAR O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14645 SW FARMINGTON RD
BEAVERTON OR
97007-2727
US

IV. Provider business mailing address

4560 SE INTERNATIONAL WAY STE -100
MILWAUKIE OR
97222-4628
US

V. Phone/Fax

Practice location:
  • Phone: 503-643-8626
  • Fax: 503-520-1435
Mailing address:
  • Phone: 971-206-5200
  • Fax: 971-206-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1000609
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: