Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Rae Icenogle

Individual provider Occupational Therapist · NPI 1982939179

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 Pl
Beaverton, OR 97006-7909
Phone: (503) 997-8954
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 241705 (OR)
Occupational Therapist Taxonomy 225X00000X · Licence 4434 (AZ)

Record details

NPI number1982939179
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 6, 2009
Last updated in NPPESOctober 6, 2009
Mailing address663 Sw 175th Pl, Beaverton, OR 97006-7909

Other providers in Beaverton