Provider Demographics
NPI:1710215173
Name:PAPPAGIANIS, ALICE DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:DENISE
Last Name:PAPPAGIANIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:DENISE
Other - Last Name:PAPPAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3131 N NORTH BANK RD
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:OR
Mailing Address - Zip Code:97368-9325
Mailing Address - Country:US
Mailing Address - Phone:541-996-7161
Mailing Address - Fax:
Practice Address - Street 1:10220 SW GREENBURG RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5503
Practice Address - Country:US
Practice Address - Phone:971-224-2032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR413161225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist