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General NPI Number Information
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NPI Number | 1942740246
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Entity Type | Individual
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Provider Name | LUKE DEPNER OTR/L
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Gender | Male
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 4640 S MACADAM AVE STE 90
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City | PORTLAND
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State | OR
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Zip | 97239-4285
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Country | US
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Telephone | 503-292-0765
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Fax |
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Provider Business Mailing Address
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Address Line | 715 SE 33RD PL
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City | PORTLAND
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State | OR
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Zip | 97214-3184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 384046
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License Number State | OR
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