Individual provider Active NPI

Pamela Latourette, OTRL

  • Occupational Therapist
  • Klamath Falls, OR
National Provider Identifier
1063634780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
40857 Issued in OR
Practice address
6510 S 6TH St PMB 73
Klamath Falls, OR 97603-7112
Phone
(541) 545-1812
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40857 OR Primary

Addresses

Primary practice location

6510 S 6TH St PMB 73
Klamath Falls, OR 97603-7112

Mailing address

6510 S 6TH St PMB 73
Klamath Falls, OR 97603-7112

Other identifiers 1

IdentifierTypeStateIssuer
031521MedicaidOR

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

LicenseStateTypeSpecialty
40857ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Physical Therapy, Inc PastSince Dec 1, 2016 Accepting new patients
Integrated Health & Wellness, LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063634780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 S 6TH ST PMB 73",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976037112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 S 6TH ST PMB 73",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976037112",
            "telephone_number": "541-545-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOURETTE",
        "first_name": "PAMELA",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "40857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031521",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.