Healthcare Provider Details

I. General information

NPI: 1669806253
Provider Name (Legal Business Name): BRITTANY L SJODEN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY COOK PT

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23415 N UMPQUA HWY
GLIDE OR
97443-0277
US

IV. Provider business mailing address

23415 N UMPQUA HWY
GLIDE OR
97443-0277
US

V. Phone/Fax

Practice location:
  • Phone: 260-301-8548
  • Fax:
Mailing address:
  • Phone: 260-301-8548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number62873
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: