IPA PHYSIO PORTLAND LLC (NPI# 1063921187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063921187 |
| Entity Type | Organization |
| Organization Name | IPA PHYSIO PORTLAND LLC |
| Practice Address |
1820 Sw Vermont St Ste F Portland OR 97219-1945 |
| Practice Telephone | 5036160313 |
| Mailing Telephone | 5036160313 |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |
| Authorized Official Name | FOSTER A KING (PARTNER / CLINIC DIRECTOR) |
| Authorized Official Telephone | 5036160313 |
| Authorized Official Credential | DPT, OCS, CFMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
05926 | OR | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | IPA PHYSIO PORTLAND LLC | 1820 Sw Vermont St Suite A, Portland, OR 97219 |
| Street Address |
1820 SW VERMONT ST STE F |
| City | PORTLAND |
| State | OR |
| Zip Code | 97219-1945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134248693 | Laura P German-mccorkle | Massage Therapist | 1820 Sw Vermont St Ste F, Portland, OR 97219-1945 | 2007-03-28 |
| 1790050888 | Sarah J Watson | Massage Therapist | 1820 Sw Vermont St Ste F, Portland, OR 97219-1945 | 2012-03-21 |
| 1073701058 | Tammy Lee Russell | Dietitian, Registered | 1820 Sw Vermont St Ste F, Portland, OR 97219-1945 | 2007-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
| 1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
| 1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
| 1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
| 1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
| 1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
| Find all providers in zip 97219 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898632 | Spine Strong Physical Therapy and Scoliosis Rehabilitation | Clinic/Center | 251 Danforth St Unit 1, Portland, ME 04102-3705 | 2020-10-13 |
| 1356969976 | Readygo Physical Therapy LLC | Clinic/Center | 904 Se 69th Ave, Portland, OR 97215-2120 | 2020-07-09 |
| 1144865841 | St. Johns Physical Therapy | Clinic/Center | 8835 N Bradford St, Portland, OR 97203-2869 | 2019-11-18 |
| 1215584446 | Patrick Franko Pt LLC | Clinic/Center | 2331 Ne 43rd Ave, Portland, OR 97213-1332 | 2019-08-22 |
| 1487112553 | Tabor Pediatric Physical Therapy LLC | Clinic/Center | 2224 Se 53rd Ave, Portland, OR 97215-3916 | 2019-03-07 |
| 1629542675 | Helen Quirk Ms Physical Therapy, LLC | Clinic/Center | 10200 Sw Eastridge St Ste 115, Portland, OR 97225-5031 | 2019-01-13 |
| 1063996585 | Physioflow | Clinic/Center | 7324 Sw Virginia Ave, Portland, OR 97219-3039 | 2018-09-20 |
| 1477084549 | Physio Pdx LLC | Clinic/Center | 2250 Nw Flanders St Ste G1, Portland, OR 97210-3475 | 2017-03-21 |
| 1417319781 | Body Mechanix | Clinic/Center | 530 Nw 23rd Ave Ste 116, Portland, OR 97210-3287 | 2016-03-24 |
| 1164899373 | Root & Branch Physical Therapy | Clinic/Center | 2232 Nw Pettygrove St, Ste 110, Portland, OR 97210 | 2015-08-24 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on IPA PHYSIO PORTLAND LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.