Provider Demographics
NPI:1811243884
Name:MORRISON-WOLLEY, SHARON L (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:MORRISON-WOLLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2714 NE 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2850
Mailing Address - Country:US
Mailing Address - Phone:503-957-0028
Mailing Address - Fax:
Practice Address - Street 1:2714 NE 38TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2850
Practice Address - Country:US
Practice Address - Phone:503-957-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR644716171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR644716OtherOCCUPATIONAL THERAPY LICENSING BOARD