MEDICARE: CLACKAMAS PHYSICAL THERAPY ASSOCIATES, INC.

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
1	174400000X	Specialist	1870	OR
2	261Q00000X	Clinic/Center	1870	OR
3	261QP2000X	Physical Therapy Clinic/Center	1870	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548443955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLACKAMAS PHYSICAL THERAPY ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	11203 SE SUNNYSIDE RD
Second Line	:
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-7787
Country	:	US
Telephone Number	:	503-698-5500
Fax Number	:	503-698-5501

Provider Business Practice Location Address
First Line	:	11203 SE SUNNYSIDE RD
Second Line	:
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-7787
Country	:	US
Telephone Number	:	503-698-5500
Fax Number	:	503-698-5501

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. CARLENE SUZANNE LEWIS
Credential	:
Telephone Number	:	503-698-5500

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	05/18/2012

Similar Medicare Providers

1679994610 — LESLIE NICOLE CLEMENTS LCSW
Practice Location Address:

11211 SE SUNNYSIDE RD
CLACKAMAS, OR
97015-7787

Practice Phone: 503-740-1971
Practice Fax: 503-781-2436

1194789453 — LARRY L MOFFETT DO
Practice Location Address:

11211 SE SUNNYSIDE RD
CLACKAMAS, OR
97015-7787

Practice Phone: 503-659-0880
Practice Fax: 503-513-7425

1629268966 — BRETT MICHAEL SULLIVAN D.M.D., M.D.
Practice Location Address:

11211 SE SUNNYSIDE RD
CLACKAMAS, OR
97015-7787

Practice Phone: 503-652-8080
Practice Fax: 503-526-8992

1609150036 — JENNIFER ANDRESON A.R.N.P
Practice Location Address:

11211 SE SUNNYSIDE RD
CLACKAMAS, OR
97015-7787

Practice Phone: 503-659-0880
Practice Fax: 503-513-7425

1629405717 — MRS. MARKI M JAMES PT, DPT
Practice Location Address:

11203 SE SUNNYSIDE RD
CLACKAMAS, OR
97015-7787

Practice Phone: 503-698-5500
Practice Fax: 503-698-5501

1114662459 — MEGAN LEANN BROCK DPT
Practice Location Address:

11203 SE SUNNYSIDE RD
CLACKAMAS, OR
97015-7787

Practice Phone: 503-698-5500
Practice Fax:

Directions to “CLACKAMAS PHYSICAL THERAPY ASSOCIATES, INC. ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.