Individual provider Active NPI

Dakota Floyd Davison, OTD

  • Occupational Therapist
  • Happy Valley, OR
National Provider Identifier
1023607769
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
385768 Issued in OR
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
OTH-007071AZMDOccupational 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.

Verify at the official NPI Registry.