Provider Demographics
NPI:1710155205
Name:PELHAM-FOSTER, SANDRA JANE (OTD, MPHA, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:JANE
Last Name:PELHAM-FOSTER
Suffix:
Gender:F
Credentials:OTD, MPHA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 NE BIRCHWOOD TER
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-3219
Mailing Address - Country:US
Mailing Address - Phone:503-313-7333
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:2008-02-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6849225XP0200X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics