Provider Demographics
NPI:1881662914
Name:SANDERS, JANET MARY (OT, CHT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARY
Last Name:SANDERS
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:MARY
Other - Last Name:BEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 965
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-0965
Mailing Address - Country:US
Mailing Address - Phone:503-318-3927
Mailing Address - Fax:503-981-2323
Practice Address - Street 1:2217 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-2811
Practice Address - Country:US
Practice Address - Phone:503-318-3927
Practice Address - Fax:503-981-2323
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR914221225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR032297Medicaid
ORP90743Medicare UPIN
OR6600350001Medicare NSC
OR6600350001Medicare NSC