Individual provider Active NPI

Emily Polis, OTD

  • Occupational Therapist
  • Portland, OR
National Provider Identifier
1679343388
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
502788 Issued in OR
Practice address
8028 E Burnside St
Portland, OR 97215-1549
Phone
(503) 502-7515
NPI assigned
Jan 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 502788 OR Primary

Addresses

Primary practice location

8028 E Burnside St
Portland, OR 97215-1549

Mailing address

8028 E Burnside St
Portland, OR 97215-1549
Phone (503) 502-7515

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

LicenseStateTypeSpecialty
502788ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Circle Pediatric Therapy, Inc CurrentSince Jan 7, 2024 Accepting new patients

Locations

8028 E Burnside St
Portland, OR 97215
Phone (503) 502-7515

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1679343388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151549",
            "telephone_number": "503-502-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151549",
            "telephone_number": "503-502-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIS",
        "first_name": "EMILY",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "502788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.