Individual provider Active NPI

Lauren Nicole Grulke, OTR/L, CLT-LANA

  • Occupational Therapist
  • Corvallis, OR
National Provider Identifier
1376126557
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
432534 Issued in OR
Practice address
815 NW 9TH St Ste 180
Corvallis, OR 97330-6173
Phone
(541) 768-5157
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 432534 OR Primary

Addresses

Primary practice location

815 NW 9TH St Ste 180
Corvallis, OR 97330-6173

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

501 NW Elks Dr
Corvallis, OR 97330-3757
Phone (541) 768-5048

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgrulke264470@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411001480 OR Practitioner - Occupational Therapist in Private Practice 6305245283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
432534ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince May 1, 2025 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince May 1, 2025 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients

Locations

501 NW Elks Dr
Corvallis, OR 97330
Phone (541) 768-4950

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

815 NW 9th St
Ste 180
Corvallis, OR 97330
Phone (541) 768-5157

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

Interoperability endpoints

  • Direct secure messaging: lgrulke264470@samhealth.direct-ci.com

Organizations & group practices 3

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1376126557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 NW 9TH ST STE 180",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306173",
            "telephone_number": "541-768-5157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 NW Elks Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303757",
            "country_code": "US",
            "telephone_number": "541-768-5048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRULKE",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "OTR/L, CLT-LANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "432534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgrulke264470@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "815 NW 9th St Ste 180",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973306173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.