Provider Demographics
NPI:1942419338
Name:REITSMA, JOANNITA SHARMAE (OTRL, QMHP-R)
Entity Type:Individual
Prefix:MS
First Name:JOANNITA
Middle Name:SHARMAE
Last Name:REITSMA
Suffix:
Gender:F
Credentials:OTRL, QMHP-R
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 1:5289 NE ELAM YOUNG PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7551
Practice Address - Country:US
Practice Address - Phone:503-747-5359
Practice Address - Fax:503-266-8632
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WAOT00003790225X00000X
CAOT 8484225XP0200X
OR1067581225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics