Marly Louise Macdonald, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT174 Issued in ID

Practice address

5571 S Ulex PL
Boise, ID 83716-6926

Phone

(208) 385-7352

NPI assigned

Mar 19, 2010

Last updated

Mar 19, 2010By 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

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": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1639493661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5571 S ULEX PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837166926",
            "telephone_number": "208-385-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5571 S ULEX PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837166926",
            "telephone_number": "208-385-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MARLY",
        "middle_name": "LOUISE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT174",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ID",
            "license": "OT174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Mac Donald, MSW, LCSW
• Ken Macanka
• Jennifer Renee Macdermott, MS, RN, ACNS-BC
• Morgan Macdermott, ND
• Katherine Rose Macdonald, MD
• Richard Macdonald, MD
• Kera Macfarlane
• Jose Machado, CSFA
• Julane Machado
• Joseph Machtinger, PMHNP-BC

• Pediatric Occupational Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Pediatric Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.