Healthcare Provider Details

I. General information

NPI: 1760163786
Provider Name (Legal Business Name): NATALIE ELISE HULL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 NE YACHT AVE
LINCOLN CITY OR
97367-5161
US

IV. Provider business mailing address

112 TALL MEADOWS LN
LAFAYETTE LA
70506-6362
US

V. Phone/Fax

Practice location:
  • Phone: 541-264-5509
  • Fax:
Mailing address:
  • Phone: 256-553-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number320473
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number418834
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: