Active NPI
Marisa Brickman, MS, OTR/L
- Specialist
- Portland, OR
National Provider Identifier
1356658603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2568
- Practice address
- 707 SW Gaines Street
CDRC Lend
Portland, OR 97239 - Phone
- (516) 456-3994
- NPI assigned
- Sep 8, 2010
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 2568 | CO | Primary |
Addresses
Primary practice location
707 SW Gaines Street
CDRC Lend
Portland, OR 97239
Mailing address
3414 SW 11TH Ave
Unit 8
Portland, OR 97239-2952
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2568 | CO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318636800000",
"number": "1356658603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3414 SW 11TH AVE",
"address_2": "UNIT 8",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW GAINES STREET",
"address_2": "CDRC LEND",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "516-456-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRICKMAN",
"first_name": "MARISA",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2011-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "2568",
"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 Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.