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NPI Code Detail

MEDICARE: MRS. WENCHE AUSTRHEIM-RUZICH OT

MEDICARE: MRS. WENCHE AUSTRHEIM-RUZICH OT
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
1225X00000XOccupational Therapist222824OR

General Provider Information

NPI Number : 1538349717
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. WENCHE AUSTRHEIM-RUZICH OT
Provider Business Mailing Address
First Line : 3269 NW BANFF DR
Second Line :
City : PORTLAND
State : OR
Zip : 97229-8226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14645 SW FARMINGTON RD
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-2727
Country : US
Telephone Number : 503-718-5355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2007
Last Update Date : 11/06/2007

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