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NPI Code Detail

MEDICARE: MOLLY NEWMAN PT

MEDICARE: MOLLY NEWMAN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist60627OR

General Provider Information

NPI Number : 1033669759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY NEWMAN PT
Provider Business Mailing Address
First Line : 6143 SW VIRGINIA AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3600
Country : US
Telephone Number : 503-901-1796
Fax Number :
Provider Business Practice Location Address
First Line : 6143 SW VIRGINIA AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3600
Country : US
Telephone Number : 503-901-1796
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2016
Last Update Date : 10/05/2016

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Directions to “ MOLLY NEWMAN PT” Practice Location

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