MEDICARE: TARA TRIEST BURROWS OTR/L

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	372600000X	Adult Companion
2	225X00000X	Occupational Therapist	399535	OR

General Provider Information

NPI Number	:	1528365020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA TRIEST BURROWS OTR/L

Provider Business Mailing Address
First Line	:	1811 SE TEMPEST DR
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-1802
Country	:	US
Telephone Number	:	510-898-8820
Fax Number	:

Provider Business Practice Location Address
First Line	:	2125 NE DAGGETT LN
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6560
Country	:	US
Telephone Number	:	541-389-1848
Fax Number	:

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

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	01/07/2020

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