IndividualActive
Lacy Hafen, COTA/L
NPI 1699130690 · Occupational Therapy Assistant · Wilsonville, OR
Provider details
- NPI number
- 1699130690
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- No
- License
- 5656 (AZ)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
25117 Sw Parkway Ave
Ste D
Wilsonville, OR 97070-9697
Phone: (971) 224-2040
Approximate (ZIP-level) locationGet directions
Mailing address
14775 W Yorkshire Dr
Surprise, AZ 85374-7224
Registry dates
- Enumerated
- 2015-12-18
- Last updated
- 2015-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.