MEDICARE: AMIE FLANAGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	339954	OR
2	224Z00000X	Occupational Therapy Assistant	7778	MT

General Provider Information

NPI Number	:	1174079396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIE FLANAGAN

Provider Business Mailing Address
First Line	:	23535 SE MCCABE RD
Second Line	:
City	:	SANDY
State	:	OR
Zip	:	97055-8419
Country	:	US
Telephone Number	:	406-390-1554
Fax Number	:

Provider Business Practice Location Address
First Line	:	3152 VALENTINE COURT
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477
Country	:	US
Telephone Number	:	951-764-8784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	10/28/2021

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Directions to “ AMIE FLANAGAN ” Practice Location

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