Healthcare Provider Details

I. General information

NPI: 1558283119
Provider Name (Legal Business Name): JESSICA MORGANN ENGLERTH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3871 FAIRVIEW INDUSTRIAL DR SE STE 120
SALEM OR
97302-1172
US

IV. Provider business mailing address

10121 SE SUNNYSIDE RD STE 208
CLACKAMAS OR
97015-5750
US

V. Phone/Fax

Practice location:
  • Phone: 503-990-6393
  • Fax: 503-212-0414
Mailing address:
  • Phone: 503-990-6393
  • Fax: 503-212-0414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number519881
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: