Provider Demographics
NPI:1225126568
Name:STEIN, PEGGY (OTD OTR/L CHT)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:OTD OTR/L CHT
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 SW 4TH ST
Mailing Address - Street 2:STE 170
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4896
Mailing Address - Country:US
Mailing Address - Phone:541-286-5445
Mailing Address - Fax:800-527-4735
Practice Address - Street 1:120 SW 4TH ST
Practice Address - Street 2:STE 170
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4896
Practice Address - Country:US
Practice Address - Phone:541-286-5445
Practice Address - Fax:800-527-4735
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60102365225X00000X
OR5918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R132679Medicare ID - Type Unspecified
WAG8887876Medicare UPIN