Individual provider Active NPI

Karen Lynn Peasley, COTA

  • Occupational Therapy Assistant
  • Milwaukie, OR
National Provider Identifier
1871065805
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
608174 Issued in OR
Practice address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone
(971) 206-5202
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 608174 OR Primary

Addresses

Primary practice location

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

Mailing address

PO Box 463
Hubbard, OR 97032-0463
Phone (503) 951-0190

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

LicenseStateTypeSpecialty
608174ORMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1871065805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "HUBBARD",
            "state": "OR",
            "postal_code": "970320463",
            "telephone_number": "503-951-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEASLEY",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OR",
            "license": "608174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.