Active NPI
Brian Eaton, MOTR/L
- Occupational Therapist
- Canby, OR
National Provider Identifier
1124793302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 406379
- Practice address
- 200 S Hazel Dell Way Ste 210
Canby, OR 97013-7828 - Phone
- (503) 263-9550
- NPI assigned
- Aug 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 406379 | OR | Primary |
Addresses
Primary practice location
200 S Hazel Dell Way Ste 210
Canby, OR 97013-7828
Mailing address
1470 NE Alberta St
Portland, OR 97211-5062
Phone (978) 886-4433
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 |
|---|---|---|---|
| 406379 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1124793302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1470 NE ALBERTA ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972115062",
"telephone_number": "978-886-4433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S HAZEL DELL WAY STE 210",
"city": "CANBY",
"state": "OR",
"postal_code": "970137828",
"telephone_number": "503-263-9550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "BRIAN",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-10",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "406379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.