Provider Demographics
NPI:1437892619
Name:FARNAM-ALAVI, EMBER SHO'LE (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:EMBER
Middle Name:SHO'LE
Last Name:FARNAM-ALAVI
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:EMBER
Other - Middle Name:SHO'LE
Other - Last Name:FARNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15584 SW SCHOLLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9276
Mailing Address - Country:US
Mailing Address - Phone:541-519-1632
Mailing Address - Fax:
Practice Address - Street 1:1815 NW 169TH PL STE 3070
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7368
Practice Address - Country:US
Practice Address - Phone:971-249-2653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR465100225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics