Healthcare Provider Details

I. General information

NPI: 1356634844
Provider Name (Legal Business Name): MARLENA E RAMOS MOT, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 A ST
SPRINGFIELD OR
97477-4766
US

IV. Provider business mailing address

826 A ST
SPRINGFIELD OR
97477-4766
US

V. Phone/Fax

Practice location:
  • Phone: 512-507-1102
  • Fax: 541-287-4463
Mailing address:
  • Phone: 512-507-1102
  • Fax: 541-287-4463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number285584
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number114295
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: