Healthcare Provider Details

I. General information

NPI: 1023516630
Provider Name (Legal Business Name): LEAH BOTT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEAH REED OT

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 CENTENNIAL LOOP STE A
EUGENE OR
97401-7917
US

IV. Provider business mailing address

2635 ALDER ST
EUGENE OR
97405-4117
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-1632
  • Fax: 541-636-3478
Mailing address:
  • Phone: 512-808-6905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number396391
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: