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
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235385139
NPI
—
05
—
182780
—
OR
01
—
1942321104
NPI
—
Enumeration date
08/20/2020
Last updated
06/02/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up