Active NPI
Sia Kruss
- Occupational Therapist
- Portland, OR
National Provider Identifier
1174032411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 391631
- Practice address
- 6010 SW Shattuck Rd
Portland, OR 97221-1043 - Phone
- (503) 246-8811
- NPI assigned
- Sep 28, 2017
- Sex
- Female
- 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 | 391631 | OR | Primary |
Addresses
Primary practice location
6010 SW Shattuck Rd
Portland, OR 97221-1043
Mailing address
12425 NW Barnes Rd Apt 43
Portland, OR 97229-6091
Phone (971) 563-2629
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 |
|---|---|---|---|
| 391631 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506556800000",
"number": "1174032411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12425 NW BARNES RD APT 43",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972296091",
"telephone_number": "971-563-2629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6010 SW SHATTUCK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972211043",
"telephone_number": "503-246-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSS",
"first_name": "SIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-28",
"last_updated": "2017-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "391631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.