Provider Demographics
NPI:1568958452
Name:ARAKAWA, OLIVIA MICHELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:MICHELLE
Last Name:ARAKAWA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:OLIVIA
Other - Middle Name:MICHELLE
Other - Last Name:MIDLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3750 SW RIVER PKWY APT 324
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4745
Mailing Address - Country:US
Mailing Address - Phone:360-789-7530
Mailing Address - Fax:
Practice Address - Street 1:14645 SW FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-2727
Practice Address - Country:US
Practice Address - Phone:503-643-8626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR402263225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation