MEDICARE: MS. SHARON L. MORRISON-WOLLEY 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	171W00000X	Contractor	644716	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	644716	OTHER	OR	OCCUPATIONAL THERAPY LICENSING BOARD

General Provider Information

NPI Number	:	1811243884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON L. MORRISON-WOLLEY OTR/L

Provider Business Mailing Address
First Line	:	2714 NE 38TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-2850
Country	:	US
Telephone Number	:	503-957-0028
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 NE 38TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-2850
Country	:	US
Telephone Number	:	503-957-0028
Fax Number	:

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

Provider Enumeration Date	:	07/27/2012
Last Update Date	:	07/27/2012

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