Active NPI
Lysse E Waring, M.O.T.R/L
- Occupational Therapist
- Portland, OR
National Provider Identifier
1912167107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 221844
- Practice address
- 13505 SE River Rd
Portland, OR 97222-8038 - Phone
- (503) 652-4011
- NPI assigned
- Jun 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 221844 | OR | Primary |
Addresses
Primary practice location
13505 SE River Rd
Portland, OR 97222-8038
Mailing address
920 SE 31St Ave
Portland, OR 97214-4067
Phone (503) 703-6445
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
| License | State | Type | Specialty |
|---|---|---|---|
| 221844 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334707200000",
"number": "1912167107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 SE 31ST AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972144067",
"telephone_number": "503-703-6445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13505 SE RIVER RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972228038",
"telephone_number": "503-652-4011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARING",
"first_name": "LYSSE",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "M.O.T.R/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-11",
"last_updated": "2012-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "221844",
"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 Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.