Healthcare Provider Details

I. General information

NPI: 1477361988
Provider Name (Legal Business Name): ICARE THERAPY OR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CENTERPOINTE DR STE 400
LAKE OSWEGO OR
97035-8661
US

IV. Provider business mailing address

825 W END AVE
NEW YORK NY
10025-5349
US

V. Phone/Fax

Practice location:
  • Phone: 866-588-8829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER DENCIGER
Title or Position: MANAGER
Credential:
Phone: 800-264-1985