Provider Demographics
NPI:1609461409
Name:BROWN, MARIT (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:MARIT
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61316 KING JOSIAH PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2858
Mailing Address - Country:US
Mailing Address - Phone:425-736-9880
Mailing Address - Fax:
Practice Address - Street 1:211 NE REVERE AVE # 7
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4010
Practice Address - Country:US
Practice Address - Phone:541-617-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR442421225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist