Rebecca Wynn, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

522367 Issued in OR

Practice address

1815 NW 169TH PL Ste 3070
Beaverton, OR 97006-7368

Phone

(971) 249-2653

Fax

(503) 747-4373

NPI assigned

Nov 11, 2024

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bold Pediatric Therapy Center Inc

  • Occupational Therapist
  • Beaverton, OR
  • NPI 1366964538
  NPD (past)

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1174347744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 NW 169TH PL STE 3070",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067368",
            "telephone_number": "971-249-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 NW 169TH PL STE 3070",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067368",
            "telephone_number": "971-249-2653",
            "fax_number": "503-747-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "REBECCA",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "522367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wu Wei Wellness LLC
• Ling-an Wu, M.D.
• Maria E. Wunderbro, LCSW
• Dahlia Wyner
• Wynn Street LLC
• Chenyong Xiang, PT
• Francisca Yac Riscajche
• Piilani Yamanoha
• Sohrob Yavari
• Kevin W.H. Yee, M.D.

• Occupational Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.