Elizabeth Ra Fertig, OTR/L

Primary specialty

Environmental Modification Occupational TherapistTaxonomy code 225XE0001X

License

476804 Issued in OR

Practice address

7150 Corvallis Rd
Independence, OR 97351-9788

Phone

(503) 838-2291

NPI assigned

Nov 6, 2009

Last updated

Nov 6, 2009By the provider in NPPES

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

Other names 1

• Beth Fertig Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1508193871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 CORVALLIS RD",
            "city": "INDEPENDENCE",
            "state": "OR",
            "postal_code": "973519788",
            "telephone_number": "503-838-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 CORVALLIS RD",
            "city": "INDEPENDENCE",
            "state": "OR",
            "postal_code": "973519788",
            "telephone_number": "503-838-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERTIG",
        "first_name": "ELIZABETH",
        "middle_name": "RA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "476804",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "OR",
            "license": "476804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "FERTIG",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mark Jeffrey Diaz, D.C.
• Doula by Angela
• Helen Dusschee
• Evan L Evans, PHD
• Evergreen Oregon Healthcare Independence, L.L.C. (Independence Health and Rehabilitation Center)
• Monica Gabaldon, LCSW
• Brandon Markeith Guidry, LMT#29563
• Gypsum Medical Associates of Oregon, PC
• Christen Marie Hammond, R.N.
• Tatiana Ariel Harden, FNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.