Active NPI
Ismira Still, OTR
- Occupational Therapist
- Wilsonville, OR
National Provider Identifier
1013488428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 397212
- Practice address
- 30900 SW Parkway Ave
Wilsonville, OR 97070-7835 - Phone
- (503) 682-2840
- NPI assigned
- Dec 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 397212 | OR | Primary |
Addresses
Primary practice location
30900 SW Parkway Ave
Wilsonville, OR 97070-7835
Mailing address
19755 Spring Ridge Dr
West Linn, OR 97068-4822
Phone (503) 560-7850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 397212 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544400000000",
"number": "1013488428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19755 SPRING RIDGE DR",
"city": "WEST LINN",
"state": "OR",
"postal_code": "970684822",
"telephone_number": "503-560-7850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30900 SW PARKWAY AVE",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970707835",
"telephone_number": "503-682-2840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILL",
"first_name": "ISMIRA",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-10",
"last_updated": "2018-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "397212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilsonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.