Active NPI
Holly Shearer, OTR/L
- Occupational Therapist
- Portland, OR
National Provider Identifier
1700339769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3488873
- Practice address
- 1425 N Killingsworth St
Portland, OR 97217-4541 - Phone
- (503) 575-9402
- Fax
- (888) 769-4431
- NPI assigned
- Jul 26, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3488873 | OR | Primary |
Addresses
Primary practice location
1425 N Killingsworth St
Portland, OR 97217-4541
Mailing address
4619 Squire CT NE
Salem, OR 97301-2044
Phone (413) 505-7786
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 348873 | Other | OR | OREGON STATE OCCUPATIONAL THERAPY LICENSURE |
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 |
|---|---|---|---|
| 3488873 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1700339769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4619 SQUIRE CT NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012044",
"telephone_number": "413-505-7786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 N KILLINGSWORTH ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972174541",
"telephone_number": "503-575-9402",
"fax_number": "888-769-4431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEARER",
"first_name": "HOLLY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "3488873",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON STATE OCCUPATIONAL THERAPY LICENSURE",
"identifier": "348873",
"state": "OR"
}
],
"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 Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.