Healthcare Provider Details

I. General information

NPI: 1346810264
Provider Name (Legal Business Name): ONE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11735 SW QUEEN ELIZABETH ST STE 103
KING CITY OR
97224-2665
US

IV. Provider business mailing address

12255 SW SILVERTIP ST
BEAVERTON OR
97007-3015
US

V. Phone/Fax

Practice location:
  • Phone: 503-941-5666
  • Fax: 503-352-9113
Mailing address:
  • Phone: 917-396-8742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: ZHUOYUAN QIAN
Title or Position: PT
Credential: PT, DPT
Phone: 917-396-8742