Healthcare Provider Details

I. General information

NPI: 1447841697
Provider Name (Legal Business Name): HOPSTOWN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2021
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3786 SW HALL BLVD
BEAVERTON OR
97005-2050
US

IV. Provider business mailing address

3786 SW HALL BLVD
BEAVERTON OR
97005-2050
US

V. Phone/Fax

Practice location:
  • Phone: 503-816-6977
  • Fax:
Mailing address:
  • Phone: 503-816-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRAD GARY SIMPSON
Title or Position: CO-OWNER
Credential: PT, DPT
Phone: 503-208-8012