Healthcare Provider Details
I. General information
NPI: 1285525998
Provider Name (Legal Business Name): TIMBER AND IRON PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10729 SE 82ND AVE
HAPPY VALLEY OR
97086-7601
US
IV. Provider business mailing address
5441 S MACADAM AVE STE 8128
PORTLAND OR
97239-6106
US
V. Phone/Fax
- Phone: 503-567-4035
- Fax:
- Phone: 503-567-4035
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
RYAN
D
ECKERT
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 916-300-2063