Active NPI
Dakota Floyd Davison, OTD
- Occupational Therapist
- Happy Valley, OR
National Provider Identifier
1023607769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 385768
- Practice address
- 14391 SE Princeton Village Way
Happy Valley, OR 97015-6263 - Phone
- (503) 433-8668
- NPI assigned
- Jan 17, 2021
- Last updated
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTH-007071 | AZ | |
| Occupational Therapist | 225X00000X | 385768 | OR | Primary |
Addresses
Primary practice location
14391 SE Princeton Village Way
Happy Valley, OR 97015-6263
Mailing address
12606 NE 37TH CT
Vancouver, WA 98686-3368
Other practice location 1
5835 NE 122nd Ave Ste 155
Portland, OR 97230-1085
Phone (503) 251-6301
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-007071 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1023607769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12606 NE 37TH CT",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986863368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14391 SE PRINCETON VILLAGE WAY",
"city": "HAPPY VALLEY",
"state": "OR",
"postal_code": "970156263",
"telephone_number": "503-433-8668"
}
],
"practiceLocations": [
{
"address_1": "5835 NE 122nd Ave Ste 155",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972301085",
"country_code": "US",
"telephone_number": "503-251-6301",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVISON",
"first_name": "DAKOTA",
"middle_name": "FLOYD",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-17",
"last_updated": "2021-08-19",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-007071",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "385768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Happy Valley, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.