Healthcare Provider Details

I. General information

NPI: 1982009247
Provider Name (Legal Business Name): TREEHOUSE THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 NE HAWTHORNE AVE
BEND OR
97701-4729
US

IV. Provider business mailing address

60679 FRONTIER WAY
BEND OR
97702-9663
US

V. Phone/Fax

Practice location:
  • Phone: 541-647-8802
  • Fax: 541-550-7956
Mailing address:
  • Phone: 541-647-8802
  • Fax: 541-550-7956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1500011088
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHRISTEN EBY
Title or Position: EXECUTIVE DIRECTOR
Credential: PT
Phone: 541-647-8802