IndividualActive
Tyler Ichiki, OTR/L
NPI 1902625825 · Hand Occupational Therapist · Gresham, OR
Provider details
- NPI number
- 1902625825
- Entity type
- Individual
- Primary specialty
- Hand Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTR/L
- Sex
- Male
- Sole proprietor
- No
- License
- 505784 (OR)
Practice location
24076 Se Stark St Ste 210
Gresham, OR 97030-3376
Phone: (503) 491-1666
Mailing address
24076 Se Stark St Ste 210
Gresham, OR 97030-3376
Registry dates
- Enumerated
- 2024-10-08
- Last updated
- 2024-10-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.