MRS. AUTUMN JESSICA CARROLL (NPI# 1871691014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871691014 |
| Entity Type | Individual |
| Full Name | MRS. AUTUMN JESSICA CARROLL |
| Credential | OTR/L |
| Practice Address |
2701 Nw Vaughn St Portland OR 97210-5311 |
| Mailing Address |
2114 N Sumner St Portland OR 97217-3831 |
| Practice Telephone | 5037216800 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-07-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | OT00004159 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225X00000X | Occupational Therapist | 1034600 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275086522 | Autumn Carroll | Pharmacist | 1 Hospital Dr Ste 3217, Asheville, NC 28801-4550 | 2016-08-03 |
| Street Address |
2701 NW VAUGHN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-5311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366424228 | Todd Jason Cruz | Physical Therapist | 2701 Nw Vaughn St, Ste 155, Portland, OR 97210-5311 | 2005-11-16 |
| 1568008803 | Jeffrey Allen Cusumano | Physical Therapist | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2019-11-21 |
| 1255855706 | Amanda J Tudeen | Occupational Therapist | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2017-07-26 |
| 1952822272 | Hannah Jane Winchester | Physical Therapist | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2017-06-28 |
| 1982078945 | Ashlee Irwin | Social Worker | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2015-11-13 |
| 1073905543 | Alejandro Nevarez | Social Worker | 2701 Nw Vaughn St, Suite 140, Portland, OR 97210-5311 | 2015-02-20 |
| 1235552209 | Christopher Danish | Social Worker | 2701 Nw Vaughn St, Suite 140, Portland, OR 97210 | 2014-01-28 |
| 1407285836 | Catherine S. Chow | Dietitian, Registered | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2013-11-06 |
| 1003181983 | Jeni Lynne Shilman | Social Worker | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2012-03-12 |
| 1558635078 | Mary Robinette H Fitzsimmons | Social Worker | 2701 Nw Vaughn St, Ste 140, Portland, OR 97210-5311 | 2012-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| 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.