MEDICARE: MICHELLE DENOV AMIR-BROWNSTEIN OTR/L, OTD

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	225XN1300X	Neurorehabilitation Occupational Therapist	369443	OR

General Provider Information

NPI Number	:	1295485233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE DENOV AMIR-BROWNSTEIN OTR/L, OTD

Provider Business Mailing Address
First Line	:	8319 SW TAYLORS FERRY RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-8951
Country	:	US
Telephone Number	:	818-307-6322
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 NE MARTIN LUTHER KING JR BLVD STE 302
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-3579
Country	:	US
Telephone Number	:	971-337-6372
Fax Number	:

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

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	03/24/2022

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