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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HOLISTIC COMMUNITY THERAPY LLC
NPI 1073179776
Occupational Therapist - Mental Health in Portland, OR

Active since May 17, 2019
1336 NW FLANDERS ST, PORTLAND, OR 97209(503) 882-0988 Get Directions Write a Review

NPPES record last updated: October 28, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 28, 2026, Jul 27, 2026, Aug 9, 2020 and 3 more (6 updates tracked since 2019).

About Holistic Community Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLISTIC COMMUNITY THERAPY LLC (NPI 1073179776) is a healthcare organization registered as a mental health in Portland, Oregon and active in the NPI registry since May 2019. The organization lists Elizabeth Martin, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1073179776
Entity TypeOrganization
Primary Taxonomy225XM0800X
Legal Business NameHOLISTIC COMMUNITY THERAPY LLC
Location Address1336 NW FLANDERS STPortland, OR 97209-2645
Mailing Address1336 Nw Flanders StPortland, OR 97209-2645 · (503) 882-0988
Phone(503) 882-0988
Organization SubpartNo
Authorized OfficialElizabeth MartinClinical Director · (503) 882-0988
Enumeration DateMay 17, 2019
Last NPPES UpdateOctober 28, 20266 updates tracked since enumeration
NPPES CertifiedOctober 28, 2026
✔ NPI 1073179776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOccupational Therapist · Mental HealthRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225XM0800X
Definition
Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to engage in normal daily occupations (work, home, family life, school, leisure). Occupational therapists provide particular emphasis on interventions that result in improved quality of life and decrease hospitalization.
Also ListedHome HealthTaxonomy 251E00000X
1336 NW FLANDERS ST, Portland, OR 97209
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holistic Community Therapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Holistic Community Therapy LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Elizabeth Martin, OTD, MHA, OTR/L
Occupational Therapist in Private Practice
NPI 1790225712
1336 NW FLANDERS ST
Portland, OR 97209
(503) 882-0988
Same address
Christine Kim, OT
Occupational Therapist in Private Practice
NPI 1770258402
1815 SW MARLOW AVE STE 110
Portland, OR 97225
(503) 292-0765
✔ Accepts Medicare5.1 mi
Cassandra Zimmerman, OTR/L
Occupational Therapist in Private Practice
NPI 1417498445
9025 NE FREMONT ST
Portland, OR 97220
(303) 907-3678
✔ Accepts Medicare5.8 mi
Dylan Gable, OTR/L
Occupational Therapist in Private Practice
NPI 1134977564
18051 SW LOWER BOONES FERRY RD APT 249
Tigard, OR 97224
(720) 383-1866
9.8 mi
Julie Allen, OT
Occupational Therapist in Private Practice
NPI 1477657567
20818 44TH AVE W STE 270
Lynnwood, WA 98036
(425) 672-9219
✔ Accepts Medicare159 mi
Kiley Petencin
Occupational Therapist in Private Practice
NPI 1639810823
1460 ELK CREEK DR
Idaho Falls, ID 83404
(208) 535-1286
✔ Accepts Medicare546 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holistic Community Therapy LLC's NPI number?

The NPI number for Holistic Community Therapy LLC is 1073179776. It was assigned to this organization in the NPPES registry on May 17, 2019.

Where is Holistic Community Therapy LLC located?

Holistic Community Therapy LLC is located at 1336 NW Flanders St, Portland, OR 97209. The listed phone number is (503) 882-0988.

What is Holistic Community Therapy LLC's specialty?

The primary specialty registered for this NPI is Occupational Therapist, specializing in Mental Health, with taxonomy code 225XM0800X.

Is Holistic Community Therapy LLC enrolled in Medicare?

Yes. Holistic Community Therapy LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Holistic Community Therapy LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Occupational Therapist in Private Practice, reassign their Medicare billing to Holistic Community Therapy LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Holistic Community Therapy LLC was last updated on October 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.