Individual provider Active NPI

Tiffany Teele Ottis, BA

  • Counselor
  • Salem, OR
National Provider Identifier
1174664148
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3000 Market St NE Ste 530
Salem, OR 97301-1835
Phone
(503) 390-5637
NPI assigned
Feb 10, 2007
Sex
Female
Sole proprietor
No

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
Counselor 101Y00000X OR Primary

Addresses

Primary practice location

3000 Market St NE Ste 530
Salem, OR 97301-1835

Mailing address

2285 Walker Rd NE
Salem, OR 97305-2655
Phone (503) 585-3752

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
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174664148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 WALKER RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973052655",
            "telephone_number": "503-585-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE STE 530",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011835",
            "telephone_number": "503-390-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTIS",
        "first_name": "TIFFANY",
        "middle_name": "TEELE",
        "name_prefix": "Mrs.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, 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.