MISS ANGIE MARIE HOLTSKI (NPI# 1275711673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275711673 |
| Entity Type | Individual |
| Full Name | MISS ANGIE MARIE HOLTSKI |
| Other Name | ANGIE MARIE RADAKOWSKI |
| Credential | OT |
| Practice Address |
11782 Sw Barnes Rd Ste 300 Portland OR 97225-5933 |
| Practice Telephone | 5032145200 |
| Practice Fax Number | 5039066613 |
| Mailing Telephone | 5032145200 |
| Mailing Fax Number | 5039066613 |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 3795-026 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OT LICENSE | 1050039 | 01 |
| Street Address |
11782 SW BARNES RD STE 300 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639284714 | Payton Alan Haynes | Specialist/Technologist | 11782 Sw Barnes Rd Ste 300, The Orthopedic & Fracture Clinic, Portland, OR 97225-5933 | 2006-08-20 |
| 1164037065 | Kelsey Marie Lavaute | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2020-09-09 |
| 1649835273 | Kevin Quangkien Mai | Occupational Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2019-05-08 |
| 1871050153 | Orthopedic & Fracture Clinic PC | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2019-02-22 |
| 1942712047 | Heath L Meir | Physician Assistant | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2017-10-30 |
| 1336650159 | Kara M Beasley | Physician Assistant | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2017-10-19 |
| 1902242506 | Jeana Lyn Summers | Neuromusculoskeletal Medicine & OMM | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2013-05-22 |
| 1447593967 | Hannah Fae Aultman | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2013-04-03 |
| 1720303308 | Richard Douglas Southgate | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2010-04-07 |
| 1891020673 | Jared Rickard Jones | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2009-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685258 | Dakota Stewart | Occupational Therapist | 12765 Nw Lovejoy St, Portland, OR 97229-4644 | 2020-10-07 |
| 1124632674 | Samantha M Mack | Occupational Therapist | 24 Hillcrest Cir, Portland, ME 04103-1443 | 2020-09-02 |
| 1639782386 | Marie Trevisan | Occupational Therapist | 4110 Ne Tillamook St Apt 307, Portland, OR 97212-5359 | 2020-08-24 |
| 1649899568 | Suzanna Braverman | Occupational Therapist | Ohsu Center for Health and Healing Rehabilitation, 3303 Sw Bond Ave, Portland, OR 97239-3098 | 2020-04-10 |
| 1265064562 | Paul Jungwirth | Occupational Therapist | 11 Russell St Apt 3, Portland, ME 04102-3161 | 2020-02-05 |
| 1144850074 | Keirstalyn Wade | Occupational Therapist | 5335 Ne Irving St, Portland, OR 97213-3157 | 2020-01-20 |
| 1083254973 | Brina Kelly | Occupational Therapist | 10 Pleasant Ave, Portland, ME 04103-3218 | 2020-01-08 |
| 1144889726 | Jessica Campbell | Occupational Therapist | 587 Riverside St, Portland, ME 04103-1289 | 2019-06-07 |
| 1366906711 | Julia Integlia Welter | Occupational Therapist | 12 Saint Lawrence St Unit 1, Portland, ME 04101-4316 | 2019-01-29 |
| 1710453840 | Amanda Sisco | Occupational Therapist | 4138 Se 76th Ave, Portland, OR 97206-3350 | 2018-10-16 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.