Julia Shannon, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1074682 Issued in OR

Practice address

4730 SW Macadam Ave Ste 201J
Portland, OR 97239-6417

Phone

(503) 707-6549

NPI assigned

Oct 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Portland Pediatric Nutrition

  • Registered Dietitian
  • Portland, OR
  • NPI 1972012409
  NPD (past)

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487843074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 SW MACADAM AVE STE 201I",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396417",
            "telephone_number": "503-707-6549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 SW MACADAM AVE STE 201J",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396417",
            "telephone_number": "503-707-6549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10424 SE Cherry Blossom Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972162825",
            "country_code": "US",
            "telephone_number": "150-370-7649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1730 SW Skyline Blvd Ste 226",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972212549",
            "country_code": "US",
            "telephone_number": "503-997-8897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JULIA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00004540",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1074682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Shannon, LMT
• Frederick Shannon
• Gabriel Shannon, LPC
• Jacqueline Riegelhaupt-Kamrin Shannon, LMFT
• Jeffery Shannon
• Julia Shannon
• Rebecca Anne Shannon
• Robbi Shannon
• Tristan Shannon
• Karl S Shao, DMD

• Occupational Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.