Ipa Physio Portland LLC
Clinic/Center, Physical Therapy in Portland, OR. Organization (NPI-2).
NPI number1063921187
StatusActive
Last updated in NPPESFeb 20, 2025
Details
- NPI
- 1063921187
- Entity type
- Organization (NPI-2)
- Legal business name
- Ipa Physio Portland LLC
- Organization subpart
- No
- Enumeration date
- Sep 20, 2017
- Certification date
- Feb 20, 2025
- Last updated
- Feb 20, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2000X | Clinic/Center, Physical Therapy | 05926 | OR | Yes |
| 225100000X | Physical Therapist | – | – |
Practice location
7412 Sw Beaverton Hillsdale Hwy Ste 110Portland, OR 97225-2167
Phone 503-616-0313
Mailing address
7412 Sw Beaverton Hillsdale Hwy Ste 110Portland, OR 97225-2167
Phone 503-616-0313
Authorized official
Kristin Foster
Office Administrator
5036160313
Is something wrong?
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All 78 Physical Therapy Clinic/Center providers in Portland · All 48,847 providers in Portland
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