MEDICARE: NAOMI KATZ OTR

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	225X00000X	Occupational Therapist	4705	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326136409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI KATZ OTR

Provider Business Mailing Address
First Line	:	PO BOX 245
Second Line	:
City	:	PHOENIX
State	:	OR
Zip	:	97535-0245
Country	:	US
Telephone Number	:	541-608-0464
Fax Number	:	541-535-5593

Provider Business Practice Location Address
First Line	:	158 SHARON DR
Second Line	:
City	:	PHOENIX
State	:	OR
Zip	:	97535-5713
Country	:	US
Telephone Number	:	541-608-0464
Fax Number	:	541-535-5593

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	04/17/2008

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