Provider Demographics
NPI:1992178040
Name:ANDERSON, ARYN RENEE (OTD OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ARYN
Middle Name:RENEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:OTD OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 SW WARM SPRINGS ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7424
Mailing Address - Country:US
Mailing Address - Phone:503-564-0565
Mailing Address - Fax:
Practice Address - Street 1:8050 SW WARM SPRINGS ST
Practice Address - Street 2:SUITE 130
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7424
Practice Address - Country:US
Practice Address - Phone:503-564-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR349441225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist