Provider Demographics
NPI:1821506130
Name:PRATT, SARAH JEAN (OTD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:PRATT
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3519
Mailing Address - Country:US
Mailing Address - Phone:503-263-8903
Mailing Address - Fax:503-266-8632
Practice Address - Street 1:610 HIGH ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2241
Practice Address - Country:US
Practice Address - Phone:503-657-8903
Practice Address - Fax:503-266-8632
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-21
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367849225X00000X
OR367849225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
367849OtherTHE NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY ( NBCOT)
OR367849OtherOREGON OCCUPATIONAL THERAPY LICENSING BOARD
OR367849OtherOREGON OCCUPATIONAL THERAPY LICENSING BOARD