Individual provider Active NPI

Brandie Ettinger, O.T.

  • Occupational Therapist
  • Portland, OR
National Provider Identifier
1013696293
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1066780 Issued in OR
Practice address
7204 SW Durham Road, Suite 100
Portland, OR 97224-7574
Phone
(503) 941-9869
Fax
(503) 352-5555
NPI assigned
Jul 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1066780 OR Primary

Addresses

Primary practice location

7204 SW Durham Road, Suite 100
Portland, OR 97224-7574

Mailing address

7204 SW Durham Rd Ste 100
Portland, OR 97224-7574
Phone (503) 941-9886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209003072 OR Practitioner - Occupational Therapist in Private Practice 9335596667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brain Rehab Network Oregon IncGroup PAC ID 8729400510, 11 clinicians

Practice addresses (Care Compare)

7204 SW Durham Rd
Suite 100
Portland, OR 97224-7574
Phone (503) 941-9869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1066780ORMDOccupational Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1013696293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7204 SW DURHAM RD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247574",
            "telephone_number": "503-941-9886",
            "fax_number": "503-352-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7204 SW DURHAM ROAD, SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247574",
            "telephone_number": "503-941-9869",
            "fax_number": "503-352-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "BRANDIE",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1066780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.