Tiffany A Waterson

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

OT-2586 Issued in ME

Practice address

2335 SE Pine St
Portland, OR 97214-1641

Phone

(207) 240-1565

NPI assigned

Apr 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1508183898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PURCHASE ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412731",
            "telephone_number": "207-240-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 SE PINE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141641",
            "telephone_number": "207-240-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERSON",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "ME",
            "license": "OT-2586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Lee Waters, GENERAL STUDIES AS
• Kirsten Karen Isakson Waters, RN, LAC
• Tracey Waters, PHARMD
• Tyrone Wayne Waters, PEER ADVOCATE LEAD
• Watershed Community Wellness LLC
• Mary C. Wathen, ARNP, CNM
• Adam C Watkins
• Alicia Watkins
• Glynis Honoria Watkins
• James E Watkins, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.