Basic Information
Provider Information
NPI: 1811516966
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUTLER
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 113 N ELM ST
Address2:  
City: CANBY
State: OR
PostalCode: 970133519
CountryCode: US
TelephoneNumber: 5032638903
FaxNumber: 5032668632
Practice Location
Address1: 2274 SW 2ND ST STE D
Address2:  
City: MCMINNVILLE
State: OR
PostalCode: 971285597
CountryCode: US
TelephoneNumber: 5032612159
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/09/2020
LastUpdateDate: 08/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X436053ORY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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