Provider Demographics
NPI:1285518282
Name:SUNGA, AGNES (OTRL)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:SUNGA
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7265 SE TAMARACK ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-3950
Mailing Address - Country:US
Mailing Address - Phone:971-425-8164
Mailing Address - Fax:
Practice Address - Street 1:8625 SW CASCADE AVE STE 320
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7126
Practice Address - Country:US
Practice Address - Phone:877-755-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR531601225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics