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Organization
WHOLE CIRCLE PEDIATRIC THERAPY, INC
Active
Organization
WHOLE CIRCLE PEDIATRIC THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIEDRA MARIE PINE OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(503) 997-1309
Entity
Organization
Contact information
Practice address
8028 E BURNSIDE ST, PORTLAND, OR 97215-1549
(503) 502-7515
(971) 382-5222
Mailing address
8028 E BURNSIDE ST, PORTLAND, OR 97215-1549
(503) 502-7515
(971) 382-5222
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/20/2020
Last updated
06/02/2022
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