Provider Demographics
NPI:1427834076
Name:GADKARI, SHRUTI UDAY (OTD, OTR/L, BCP)
Entity type:Individual
Prefix:DR
First Name:SHRUTI
Middle Name:UDAY
Last Name:GADKARI
Suffix:
Gender:F
Credentials:OTD, OTR/L, BCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11029 SW TUALATIN RD
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8043
Mailing Address - Country:US
Mailing Address - Phone:213-400-5364
Mailing Address - Fax:
Practice Address - Street 1:1500 NW BETHANY BLVD STE 195
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5235
Practice Address - Country:US
Practice Address - Phone:503-346-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR290467225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist