Provider Demographics
NPI:1841426046
Name:MERRICK, CATHERINE MARGARET (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARGARET
Last Name:MERRICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 NE GLISAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2933
Mailing Address - Country:US
Mailing Address - Phone:503-215-5945
Mailing Address - Fax:503-215-6394
Practice Address - Street 1:6010 SW SHATTUCK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221
Practice Address - Country:US
Practice Address - Phone:971-206-5200
Practice Address - Fax:971-206-5203
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR248411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR248411OtherSTATE OF OREGON OT LICENSING BOARD
248411OtherNBCOT