Provider Demographics
NPI:1295485233
Name:AMIR-BROWNSTEIN, MICHELLE DENOV (OTR/L, OTD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DENOV
Last Name:AMIR-BROWNSTEIN
Suffix:
Gender:F
Credentials:OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8319 SW TAYLORS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8951
Mailing Address - Country:US
Mailing Address - Phone:818-307-6322
Mailing Address - Fax:
Practice Address - Street 1:11 NE MARTIN LUTHER KING JR BLVD STE 302
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-3579
Practice Address - Country:US
Practice Address - Phone:971-337-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR369443225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation