Diedra M Pine, MOT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

01060048 Issued in OR

Practice address

1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102

Phone

(503) 802-5261

Fax

(503) 905-6159

NPI assigned

Apr 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Pediatric Occupational Therapy Solutions, LLC

  • Pediatric Occupational Therapist
  • Portland, OR
  • NPI 1841854163

  Pediatrics

  NPD Authorized official
• Whole Circle Pediatric Therapy, Inc

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1649882549

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942321104",
    "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": "503-289-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255102",
            "telephone_number": "503-802-5261",
            "fax_number": "503-905-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINE",
        "first_name": "DIEDRA",
        "middle_name": "M",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "01060048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel L Pincetich, L.M.T.
• Sandra Kay Pinches, PH.D.
• Alexander James Pinck, COTA/L
• Montana Pindell, CSWA
• Pine Mountain Counseling
• Pinecrest Senior Villa
• Amy Pineda, PT
• Jorge Alberto Pineda Jr., M.D.
• Fatima Pinedo Botello
• Andrea Sue Pinedo

• 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 Jul 8, 2007; 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.