Provider Demographics
NPI:1386107779
Name:MARTI, MEGAN LEE (OTR/L)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEE
Last Name:MARTI
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 1:2614 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1225
Mailing Address - Country:US
Mailing Address - Phone:201-736-3001
Mailing Address - Fax:
Practice Address - Street 1:1000 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-7105
Practice Address - Country:US
Practice Address - Phone:833-574-1647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5354225X00000X
NC11792225X00000X
NY022073-1225X00000X
NJ46TR00812800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist