Healthcare Provider Details

I. General information

NPI: 1144927500
Provider Name (Legal Business Name): GARY LEE PIPER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1166 E 28TH AVE
EUGENE OR
97403-1615
US

IV. Provider business mailing address

8947 E PLANA AVE
MESA AZ
85212-2851
US

V. Phone/Fax

Practice location:
  • Phone: 541-345-0534
  • Fax:
Mailing address:
  • Phone: 828-451-8996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA-014606
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPA6852
License Number StateME

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: