Andrea Rae Icenogle
Andrea Rae Icenogle is an Occupational Therapist in Beaverton, Oregon. Licensed in Arizona and Oregon. Registered with an NPI since 2009.
- Licensed in
- AZ, OR
- In the registry since
- 2009
- Specialties on file
- 2
Practice location Address checks out
663 SW 175th PlBeaverton, OR 97006-7909
Phone: (503) 997-8954
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Specialties & licences
| Occupational Therapist (primary) | Taxonomy 225X00000X · Licence 241705 (OR) |
|---|---|
| Occupational Therapist | Taxonomy 225X00000X · Licence 4434 (AZ) |
Record details
| NPI number | 1982939179 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | October 6, 2009 |
| Last updated in NPPES | October 6, 2009 |
| Mailing address | 663 Sw 175th Pl, Beaverton, OR 97006-7909 |
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