Individual provider Active NPI

McKenzie Hull, OTR/L

  • Occupational Therapist
  • Tualatin, OR
National Provider Identifier
1669844171
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
349715 Issued in OR
Practice address
19250 SW 65TH Ave Ste 125
Tualatin, OR 97062
Phone
(503) 413-4505
Fax
(503) 413-4719
NPI assigned
Oct 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056011253 IL
Occupational Therapist 225X00000X 349715 OR Primary

Addresses

Primary practice location

19250 SW 65TH Ave Ste 125
Tualatin, OR 97062

Mailing address

1650 NW Naito Pkwy Ste 185
Portland, OR 97209-2535
Phone (971) 983-5260

Other practice location 1

2300 N Childrens Plz
Box #46
Chicago, IL 60614-3363
Phone (312) 227-6244

Other identifiers 1

IdentifierTypeStateIssuer
500760019MedicaidOR

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056011253ILMDOccupational Therapist
349715ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1669844171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 NW NAITO PKWY STE 185",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092535",
            "telephone_number": "971-983-5260",
            "fax_number": "971-983-5326"
        },
        {
            "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": "97062",
            "telephone_number": "503-413-4505",
            "fax_number": "503-413-4719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 N Childrens Plz",
            "address_2": "Box #46",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606143363",
            "country_code": "US",
            "telephone_number": "312-227-6244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULL",
        "first_name": "MCKENZIE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011253",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "349715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500760019",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.