PT NORTHWEST LLC (NPI# 1417934886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417934886 |
| Entity Type | Organization |
| Organization Name | PT NORTHWEST LLC |
| Practice Address |
685 36th Ave Ne Salem OR 97301-0005 |
| Mailing Address |
685 36th Ave Ne Salem OR 97301-4741 |
| Practice Telephone | 5033718860 |
| Practice Fax Number | 5033719299 |
| Mailing Telephone | 5035408701 |
| Mailing Fax Number | 5033718772 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2013-06-12 |
| Authorized Official Name | KENNEDY I HAWKINS (PRESIDENT GENERAL MANAGER) |
| Authorized Official Telephone | 5035408701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities | ||
| N | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
Ambulatory Health Care Facilities | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE ID TYPE UNSPECIFIED | 386522 | 01 |
| Street Address |
685 36TH AVE NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-0005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225636772 | Erik Cronrath | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2020-10-15 |
| 1548875115 | Karissa Wells | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2020-09-10 |
| 1578173506 | Kayla Winter | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2020-08-04 |
| 1326657115 | Erik Keating | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2020-07-28 |
| 1235757386 | Caeli Brannon | Occupational Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2020-07-06 |
| 1457833030 | Kelsey Sandage | Occupational Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2018-08-30 |
| 1841780426 | Jordon Reyes | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2018-05-18 |
| 1700376100 | Mary Enid Brookes | Occupational Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2018-05-11 |
| 1487152278 | Eric Michael Jones | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2018-01-26 |
| 1447763966 | Mark Eugene Rohde | Physical Therapist | 685 36th Ave Ne, Salem, OR 97301-4741 | 2017-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518448 | Shira Lauren Dragun | Clinic/Center | 63 1/2 Jefferson Ave, Salem, MA 01970-2975 | 2020-11-03 |
| 1548736028 | Vibrance Physical Therapy LLC | Clinic/Center | 3295 Triangle Dr Se Ste 140, Salem, OR 97302-4566 | 2018-10-22 |
| 1881850634 | Clemson Sports Medicine and Rehabilitation | Clinic/Center | 1051 Stamp Creek Rd, Salem, SC 29676-4516 | 2008-07-31 |
| 1558495762 | Performance Zone Sports and Orthopedic Physical Therapy Inc. | Clinic/Center | 2138 Lancaster Dr Ne, Suite 103, Salem, OR 97305-1227 | 2007-03-16 |
| 1063437747 | Apex Physical Therapy, LLC | Clinic/Center | 1875 W Main St, Salem, IL 62881-5839 | 2006-07-13 |
| 1467450437 | Richfield Wellness and Rehab, Inc. | Clinic/Center | 3737 W Main St, Salem, VA 24153-2072 | 2005-07-13 |
| 1124630850 | Kevin Carl Manabe Coriano | Clinic/Center | 631 Jason St Ne, Salem, OR 97301-2357 | 2020-08-24 |
| 1861003287 | Kevin Carl Manabe Coriano | Clinic/Center | 631 Jason St Ne, Salem, OR 97301-2357 | 2020-08-10 |
| 1225214539 | Select Physical Therapy Holdings Inc | Clinic/Center | 7 Stiles Rd, Suite 104, Salem, NH 03079-4881 | 2008-01-16 |
| 1275738221 | Total Life Physical Therapy LLC | Clinic/Center | 5 Public Sq, Salem, IN 47167-2050 | 2007-06-19 |
| Find all providers in SALEM | ||||
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| 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.