Basic Information
Provider Information
NPI: 1396723177
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOPKINS
FirstName: ANNE
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: OTR L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2003 BERNDT HILL DR S
Address2:  
City: SALEM
State: OR
PostalCode: 97302
CountryCode: US
TelephoneNumber: 5033646471
FaxNumber:  
Practice Location
Address1: 290 MAYER LANE NW
Address2:  
City: SALEM
State: OR
PostalCode: 97304
CountryCode: US
TelephoneNumber: 5033708990
FaxNumber: 5033634214
Other Information
ProviderEnumerationDate: 01/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X1020785ORY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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