NPIMap

Organization Active NPI

Bold Pediatric Therapy Center Inc

  • Occupational Therapist
  • Beaverton, OR
National Provider Identifier
1366964538
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
BOLD PEDIATRIC THERAPY CENTER INC
Practice address
1815 NW 169TH PL Ste 3070
Beaverton, OR 97006-7368
Phone
(971) 249-2653
NPI assigned
Jul 10, 2017
Last updated
Jul 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

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

Authorized official

Name
Dr. Sandra Pelham-Foster, OTD, MPHA, OTR/LNPI 1710155205
Title
Director /Owner
Phone
(503) 313-7333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OR Primary

Addresses

Primary practice location

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

Mailing address

409 NE Birchwood Ter
Hillsboro, OR 97124-3219
Phone (503) 313-7333

National Provider Directory

National Provider Directory

Locations

1815 NW 169th Pl
Ste 3070
Beaverton, OR 97006
Phone (971) 249-2653

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499644800000",
    "number": "1366964538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 NE BIRCHWOOD TER",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971243219",
            "telephone_number": "15033137333"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLD PEDIATRIC THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A",
        "authorized_official_last_name": "PELHAM-FOSTER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "DIRECTOR /OWNER",
        "authorized_official_telephone_number": "503-313-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTD, MPHA, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.