Individual
REBECCA ANNE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5220 NE SACRAMENTO ST, PORTLAND, OR 97213-2666
(971) 888-5265
Mailing address
4314 SE 42ND AVE, PORTLAND, OR 97206-4176
(206) 660-0471
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1070704
OR
225XP0200X
Pediatric Occupational Therapist
Primary
1070704
OR
Other
Enumeration date
09/20/2006
Last updated
09/14/2021
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