Individual provider Active NPI

Elizabeth Martin, OTD, MHA, OTR/L

  • Mental Health Occupational Therapist
  • Portland, OR
National Provider Identifier
1790225712
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Occupational TherapistTaxonomy code 225XM0800X
License
349133 Issued in OR
Practice address
1336 NW Flanders St
Portland, OR 97209-2645
Phone
(503) 882-0988
NPI assigned
Feb 24, 2017
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Occupational Therapist 225XM0800X 349133 OR Primary
Occupational Therapist 225X00000X 349133 OR

Addresses

Primary practice location

1336 NW Flanders St
Portland, OR 97209-2645

Mailing address

1336 NW Flanders St
Portland, OR 97209-2645
Phone (503) 882-0988

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111001790 OR Practitioner - Occupational Therapist in Private Practice 1456783521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
349133ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Community Therapy LLC Mental Health CurrentSince May 19, 2019 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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1790225712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 NW FLANDERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092645",
            "telephone_number": "503-882-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 NW FLANDERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092645",
            "telephone_number": "503-882-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OTD, MHA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "OR",
            "license": "349133",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "349133",
            "primary": false
        }
    ],
    "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.