Mary Grace Madison, OTR | |
4131 Se Grant St, Portland, OR 97214-5936 | |
(816) 896-9386 | |
Not Available |
Full Name | Mary Grace Madison |
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Gender | Female |
Speciality | Occupational Therapist |
Location | 4131 Se Grant St, Portland, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346773124 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 1001320 (Oregon) | Primary |
225X00000X | Occupational Therapist | 2005040669 (Missouri) | Secondary |
Provider Name | Aegis Group Practice Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1558819508 PECOS PAC ID: 5193036432 Enrollment ID: O20161109000544 |
Mailing Address | Practice Location Address |
---|---|
Mary Grace Madison, OTR 4131 Se Grant St, Portland, OR 97214-5936 Ph: (816) 896-9386 | Mary Grace Madison, OTR 4131 Se Grant St, Portland, OR 97214-5936 Ph: (816) 896-9386 |
Ms. Margaret Wolf, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 707 Sw Gaines St, Portland, OR 97239 Phone: 503-494-8095 | |
Steps 2 Grow Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2870 Nw Cornell Rd, Portland, OR 97210 Phone: 503-720-4634 Fax: 844-250-7399 | |
Pido Tran Maas, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 9135 Sw Barnes Rd Ste 561, Portland, OR 97225 Phone: 503-216-2339 | |
Kristy K Mcfarland, MOT, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 501 N Dixon St, Portland, OR 97227 Phone: 503-916-5570 | |
Kari A Jones, M.S., OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 Phone: 503-802-5318 | |
Sara Kelly, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: Po Box 4105, Portland, OR 97208 Phone: 866-907-1068 Fax: 425-917-9141 | |
Brandie Ettinger, O.T. Occupational Therapist Medicare: Medicare Enrolled Practice Location: 7204 Sw Durham Road, Suite 100, Portland, OR 97224 Phone: 503-941-9869 Fax: 503-352-5555 |