Provider Demographics
NPI:1659489086
Name:NEEVEL, DONNA LOUISE (OTR/LD)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LOUISE
Last Name:NEEVEL
Suffix:
Gender:F
Credentials:OTR/LD
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:LOUISE
Other - Last Name:HUSSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:13875 SW BONNIE BRAE ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4338
Mailing Address - Country:US
Mailing Address - Phone:503-644-6136
Mailing Address - Fax:
Practice Address - Street 1:4855 SW WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3460
Practice Address - Country:US
Practice Address - Phone:503-643-7565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR114785225X00000X
WA114785225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist