Heidi Jo Aiken, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Portland, OR

NPI 1154851533 · NPPES record last updated Jun 18, 2017

Key facts

NPI
1154851533
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1052199 (OR)
Practice address
12441 SE Stark St
Portland, OR 97233-1053
Phone
(503) 255-7040
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1052199ORMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1052199 OR Yes

Addresses

Primary practice location

12441 SE Stark St
Portland, OR 97233-1053

Mailing address

5812 N Wilbur Ave
Portland, OR 97217-4227
Phone (541) 310-9545

Other providers in Portland, OR

All providers in Portland, OR · Occupational Therapy Assistant in Oregon

Sources for this page

Verify at the official NPI Registry.