Individual
SAMARA NOVA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
1225 NE 2ND AVE, PORTLAND, OR 97232-2003
(503) 944-8000
Mailing address
11487 SE 60TH AVE, MILWAUKIE, OR 97222-2727
(480) 570-7179
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
OR
Other
Enumeration date
04/06/2023
Last updated
12/06/2023
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