Healthcare Provider Details

I. General information

NPI: 1700656584
Provider Name (Legal Business Name): BETHANY KARIN MCWILLIAMS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60575 BILLADEAU RD
BEND OR
97702-9338
US

IV. Provider business mailing address

1318 NE HOLLINSHEAD DR
BEND OR
97701-3715
US

V. Phone/Fax

Practice location:
  • Phone: 360-301-5657
  • Fax:
Mailing address:
  • Phone: 360-301-5657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number506146
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number506146
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: