Provider Demographics
NPI:1558569855
Name:SITTLER, GEOFFREY DAVID (OTR)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:DAVID
Last Name:SITTLER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 NW 6TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3609
Mailing Address - Country:US
Mailing Address - Phone:503-200-3923
Mailing Address - Fax:503-241-7419
Practice Address - Street 1:727 WEST BURNSIDE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3514
Practice Address - Country:US
Practice Address - Phone:503-228-4533
Practice Address - Fax:503-228-4618
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR220996225X00000X
WAOT00004421225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist