Active NPI
Miriam Krisitiyahna White, OTD, OTR/L
- Occupational Therapist
- Tualatin, OR
National Provider Identifier
1639402027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 278883
- Practice address
- 19250 SW 65TH Ave Ste 125
Tualatin, OR 97062-7745 - Phone
- (503) 692-1670
- Fax
- (503) 692-1669
- NPI assigned
- Sep 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Occupational Therapist | 225X00000X | 278883 | OR | Primary |
Addresses
Primary practice location
19250 SW 65TH Ave Ste 125
Tualatin, OR 97062-7745
Mailing address
PO Box 6689
Portland, OR 97228-6689
Phone (503) 413-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 278883 | OR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Meridian Park Pediatric Rehab | Past | Accepting new patients | |
| Legacy Meridian Park Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Hospitalist Physician
- Tualatin, OR
- NPI 1023305034
-
- Children's Rehabilitation Hospital
- Tualatin, OR
- NPI 1801122593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1639402027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6689",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972286689",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19250 SW 65TH AVE STE 125",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627745",
"telephone_number": "503-692-1670",
"fax_number": "503-692-1669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "MIRIAM",
"middle_name": "KRISITIYAHNA",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-16",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "278883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
- Luana West Machado Hearn, MD
- Western Psychological and Counseling Services LLC
- Laurel M Westly, M.D.
- Mark Cecil Weston, M.D.
- Jacob White, PHARMD
- Rachel Finn White, DPT
- Jason Wilkinson
- Willamette Dermatology, P.C.
- Willamette General & Colon-Rectal Surgery PC
- Willamette General & Vascular Surgery, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.