Individual provider Active NPI

Christine Kim, OT

  • Occupational Therapist
  • Portland, OR
National Provider Identifier
1770258402
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
394862 Issued in OR
Practice address
1815 SW Marlow Ave Ste 110
Portland, OR 97225-5186
Phone
(503) 292-0765
Fax
(503) 292-5208
NPI assigned
Aug 13, 2021
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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 394862 OR Primary

Addresses

Primary practice location

1815 SW Marlow Ave Ste 110
Portland, OR 97225-5186

Mailing address

1815 SW Marlow Ave Ste 110
Portland, OR 97225-5186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210907003062 OR Practitioner - Occupational Therapist in Private Practice 7315343902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holistic Community Therapy LLCGroup PAC ID 0547692618, 2 clinicians

Practice addresses (Care Compare)

1336 NW Flanders St
Portland, OR 97209-2645

4339 NE 115TH Ave
Portland, OR 97220-1409
Phone (503) 882-0988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
394862ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Community Therapy LLC CurrentSince May 5, 2025 Accepting new patients

Locations

1336 NW Flanders St
Portland, OR 97209
Phone (503) 882-0988

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1770258402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SW MARLOW AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 SW MARLOW AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255186",
            "telephone_number": "503-292-0765",
            "fax_number": "503-292-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTINE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "394862",
            "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 Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.