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

Individual provider Occupational Therapist · NPI 1003075417

Nicole Elledge, OTR is an Occupational Therapist in Private Practice in Lake Oswego, Oregon. Qualified in 2002, 24 years ago. Practices with Tsl Well LLC, a 12-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
24
Licensed in
OR
In the registry since
2008
What do these letters mean?
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

3900 Kruse Way Pl
Lake Oswego, OR 97035-2512
Phone: (503) 607-0566
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1900 Fulton St, Newberg, OR 97132-1806 — (503) 538-2108

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 1060547 (OR)

Record details

NPI number1003075417
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR
Sole proprietorYes
NPI enumeratedJune 2, 2008
Last updated in NPPESMay 6, 2022
Certification dateMay 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Tsl Well Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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