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NPI Code Detail

MEDICARE: UPPER LEFT PHYSICAL THERAPY AND SPORT PERFORMANCE, LLC

MEDICARE: UPPER LEFT PHYSICAL THERAPY AND SPORT PERFORMANCE, LLC
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 Therapist

General Provider Information

NPI Number : 1174481857
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPPER LEFT PHYSICAL THERAPY AND SPORT PERFORMANCE, LLC
Provider Business Mailing Address
First Line : 3136 SE 63RD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97206-1902
Country : US
Telephone Number : 325-642-6132
Fax Number :
Provider Business Practice Location Address
First Line : 3136 SE 63RD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97206-1902
Country : US
Telephone Number : 325-642-6132
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DUSTIN ZINK
Credential :
Telephone Number : 325-642-6132
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “UPPER LEFT PHYSICAL THERAPY AND SPORT PERFORMANCE, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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