Provider Demographics
NPI:1144469834
Name:MURPHY, MAURA SIOBHAN (OT)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:SIOBHAN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 NW ITHACA AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2114
Mailing Address - Country:US
Mailing Address - Phone:650-315-5140
Mailing Address - Fax:
Practice Address - Street 1:1434 NW ITHACA AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2114
Practice Address - Country:US
Practice Address - Phone:650-315-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT10519225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT10519OtherLICENSE NUMBER
OROT246359OtherLICENSE NUMBER