Provider Demographics
NPI:1699215723
Name:FOUTS, STEPHANIE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:FOUTS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:STE. 210
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9400 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:STE. 210
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3315
Practice Address - Country:US
Practice Address - Phone:503-352-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR379853225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist