Pediatric Occupational Therapy Solutions, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

PEDIATRIC OCCUPATIONAL THERAPY SOLUTIONS, LLC

Practice address

5220 NE Sacramento St
Portland, OR 97213-2666

Phone

(503) 997-1309

Fax

(971) 888-5266

NPI assigned

Apr 23, 2019

Last updated

Apr 23, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diedra Marie Pine, OTLNPI 1942321104

Title

Occupational Therapist/Owner

Phone

(503) 997-1309

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diedra M Pine, MOT

  • Pediatric Occupational Therapist
  • Portland, OR
  • NPI 1942321104

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555977600000",
    "number": "1841854163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4548 NE HOLMAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181349",
            "telephone_number": "503-997-1309",
            "fax_number": "971-888-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 NE SACRAMENTO ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132666",
            "telephone_number": "503-997-1309",
            "fax_number": "971-888-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC OCCUPATIONAL THERAPY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A",
        "authorized_official_last_name": "PINE",
        "authorized_official_first_name": "DIEDRA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "503-997-1309",
        "authorized_official_credential": "OTL"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500189782",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diedra@groundplaytherapy.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4548 NE Holman St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972181349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Occupational Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.