Provider Demographics
NPI:1356654552
Name:BECKER-NUNLEY, ASHLEY TAI (MOT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:TAI
Last Name:BECKER-NUNLEY
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 N DRUMMOND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-6161
Mailing Address - Country:US
Mailing Address - Phone:503-347-6557
Mailing Address - Fax:
Practice Address - Street 1:8601 N DRUMMOND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-6161
Practice Address - Country:US
Practice Address - Phone:503-347-6557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist