Healthcare Provider Details

I. General information

NPI: 1659688778
Provider Name (Legal Business Name): THERAPEUTIC ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NE NEFF RD SUITE 202
BEND OR
97701-4283
US

IV. Provider business mailing address

16083 SW UPPER BOONES FERRY RD SUITE 300
TIGARD OR
97224-7736
US

V. Phone/Fax

Practice location:
  • Phone: 541-388-7738
  • Fax: 541-312-0121
Mailing address:
  • Phone: 800-219-8835
  • Fax: 503-639-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateOR

VIII. Authorized Official

Name: MR. TODD R GIFFORD
Title or Position: COO
Credential:
Phone: 800-219-8835