Provider Demographics
NPI:1215442744
Name:SAMPSON, VALERY BRISBANE (OTR/L)
Entity type:Individual
Prefix:
First Name:VALERY
Middle Name:BRISBANE
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 VILLA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1860
Mailing Address - Country:US
Mailing Address - Phone:503-537-3546
Mailing Address - Fax:
Practice Address - Street 1:500 VILLA RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1860
Practice Address - Country:US
Practice Address - Phone:503-537-3546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist