Provider Demographics
NPI:1407486632
Name:MURPHY, CODY ALLEN (COTA/L)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:ALLEN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:QUEEN CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63561-2341
Mailing Address - Country:US
Mailing Address - Phone:660-956-2581
Mailing Address - Fax:
Practice Address - Street 1:4560 SE INTERNATIONAL WAY STE 100
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-4628
Practice Address - Country:US
Practice Address - Phone:971-202-0652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant