Individual provider Active NPI

Lisa Walker

  • Occupational Therapy Assistant
  • Canby, OR
National Provider Identifier
1275005878
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
475020 Issued in OR
Practice address
1577 S Ivy St
Canby, OR 97013-4334
Phone
(503) 266-5541
NPI assigned
Dec 19, 2018
Last updated
Dec 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 475020 OR Primary

Addresses

Primary practice location

1577 S Ivy St
Canby, OR 97013-4334

Mailing address

4560 SE International Way
Milwaukie, OR 97222-4628
Phone (971) 206-5202

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

LicenseStateTypeSpecialty
475020ORMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists California, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1275005878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5202",
            "fax_number": "971-206-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 S IVY ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970134334",
            "telephone_number": "503-266-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OR",
            "license": "475020",
            "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 Dec 19, 2018; 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.