Provider Demographics
NPI:1801419874
Name:HILL, CLARISSA Y
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:Y
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25117 SW PARKWAY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:971-255-4079
Mailing Address - Fax:
Practice Address - Street 1:343 WELLSIAN WAY STE 103
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4107
Practice Address - Country:US
Practice Address - Phone:509-392-3773
Practice Address - Fax:509-362-9693
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-25
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32003482A224Z00000X
WAOC61075970224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant