Otis Heavenrich

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14050779 Issued in OR

Practice address

785 Alameda Ave
Astoria, OR 97103-5947

Phone

(503) 338-8225

NPI assigned

Feb 14, 2024

Sex

Male

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": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1518722016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35218 MUDD LN",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971038337",
            "telephone_number": "503-338-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 ALAMEDA AVE",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971035947",
            "telephone_number": "503-338-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVENRICH",
        "first_name": "OTIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "14050779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Ray Harrison, D.D.S.
• Rebecca Ann Hart, LMT, LMP
• Pehr Hartvigson, MD
• Kalehua Kawehiokalani Harward, PHARM. D
• Heather a. Bee Psy.D., LLC, Licensed Psychologist
• Richard Martin Hedlund, MA
• Helping Hands Re-Entry Outreach Centers
• Wendy Hemsley, CADC 1
• Melissa Henige
• Sarah Henry

• Speech-Language Pathologist in Astoria, OR
• Providers in Astoria, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.