Healthcare Provider Details

I. General information

NPI: 1982967188
Provider Name (Legal Business Name): JENNIFER WOODRUFF PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14780 SW OSPREY DR STE 241
BEAVERTON OR
97007-8424
US

IV. Provider business mailing address

9236 SW MACKAYLA PL
PORTLAND OR
97223-1148
US

V. Phone/Fax

Practice location:
  • Phone: 971-246-7478
  • Fax: 971-249-3191
Mailing address:
  • Phone: 917-714-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number32168
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number65553
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: