Individual
ANNA VIVATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4640 S MACADAM AVE STE 90, PORTLAND, OR 97239-4285
(503) 292-0765
Mailing address
4717 SE HAWTHORNE BLVD APT 208, PORTLAND, OR 97215-3300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
527318
OR
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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