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NPI Code Detail

MEDICARE: MOLLY G SPOHN COTA/L

MEDICARE: MOLLY G SPOHN COTA/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
1224Z00000XOccupational Therapy Assistant393649OR

General Provider Information

NPI Number : 1538972336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY G SPOHN COTA/L
Provider Business Mailing Address
First Line : 5330 NE PRESCOTT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97218-2158
Country : US
Telephone Number : 503-288-6585
Fax Number :
Provider Business Practice Location Address
First Line : 5330 NE PRESCOTT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97218-2158
Country : US
Telephone Number : 503-288-6585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2025
Last Update Date : 03/24/2026

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Directions to “ MOLLY G SPOHN COTA/L” Practice Location

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