Healthcare Provider Details

I. General information

NPI: 1821201849
Provider Name (Legal Business Name): PAUL JOSEPH SAWICKI P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 6TH AVE SW
ALBANY OR
97321-1916
US

IV. Provider business mailing address

845 SW 30TH ST
CORVALLIS OR
97331-8629
US

V. Phone/Fax

Practice location:
  • Phone: 541-812-4962
  • Fax:
Mailing address:
  • Phone: 541-768-7700
  • Fax: 541-768-9784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4652
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: