Provider Demographics
NPI:1710607585
Name:NOAM, DAFNA SHARON (OTR/L)
Entity Type:Individual
Prefix:
First Name:DAFNA
Middle Name:SHARON
Last Name:NOAM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DAFNI
Other - Middle Name:
Other - Last Name:NOAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24076 SE STARK ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3376
Mailing Address - Country:US
Mailing Address - Phone:503-674-7860
Mailing Address - Fax:503-674-7642
Practice Address - Street 1:24076 SE STARK ST STE 200
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3376
Practice Address - Country:US
Practice Address - Phone:503-674-7860
Practice Address - Fax:503-674-7642
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR324932225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist