# AN INTEGRATED LIFE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225435100
- **Authorized official:** JULIA A SHANNON OTR/L (CEO)
- **Authorized official phone:** (503) 707-6549

## Contact information

- **Practice address:** 6022 SW KELLY AVE, PORTLAND, OR 97239-3733
- **Practice address phone:** (608) 347-0667
- **Mailing address:** 4730 SW MACADAM AVE STE 201J, PORTLAND, OR 97239-6417
- **Mailing address phone:** (503) 707-6549
- **Mailing address fax:** (503) 974-8543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 1074682 | OR | Yes |

## Other

- **Enumeration date:** 11/20/2014
- **Last updated:** 12/12/2017