Individual provider Active NPI

Debra L Staylor, OTR CHT

  • Hand Occupational Therapist
  • Tualatin, OR
National Provider Identifier
1740280361
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
512673 Issued in OR
Practice address
19365 SW 65TH Ave Ste 200
Tualatin, OR 97062-9196
Phone
(503) 692-5210
Fax
(503) 692-8821
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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 512673 OR
Hand Occupational Therapist 225XH1200X 512673 OR Primary

Addresses

Primary practice location

19365 SW 65TH Ave Ste 200
Tualatin, OR 97062-9196

Mailing address

19365 SW 65TH Ave Ste 200
Tualatin, OR 97062-9196
Phone (503) 692-5210

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
512673ORMDHand Occupational Therapist

Interoperability endpoints

  • Direct secure messaging: debra.staylor.1@9008.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1740280361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19365 SW 65TH AVE STE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629196",
            "telephone_number": "503-692-5210",
            "fax_number": "503-692-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19365 SW 65TH AVE STE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629196",
            "telephone_number": "503-692-5210",
            "fax_number": "503-692-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAYLOR",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "OTR CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "512673",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "OR",
            "license": "512673",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 20, 2007; 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.