MEDICARE: BRIAN TOOGOOD

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	225100000X	Physical Therapist	60742	OR

General Provider Information

NPI Number	:	1821498825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN TOOGOOD

Provider Business Mailing Address
First Line	:	7754 SE MILWAUKIE AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-6117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6936 N FATHOM ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-3928
Country	:	US
Telephone Number	:	503-680-3627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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Directions to “ BRIAN TOOGOOD ” Practice Location

Language	Start Address	Practice Location

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