Provider Demographics
NPI:1760466189
Name:RUFF, SANDRA B (OTR, CHT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:B
Last Name:RUFF
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 MERCANTILE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2556
Mailing Address - Country:US
Mailing Address - Phone:503-850-9950
Mailing Address - Fax:866-252-2247
Practice Address - Street 1:4103 MERCANTILE DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2556
Practice Address - Country:US
Practice Address - Phone:503-850-9950
Practice Address - Fax:866-252-2247
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003326225XH1200X
OR778225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR098565020OtherBCBSO
WA8419921Medicaid
WA130665OtherWA L&I
OR230522Medicaid
OR116353Medicare ID - Type Unspecified