Healthcare Provider Details
I. General information
NPI: 1265800668
Provider Name (Legal Business Name): THERAPEUTIC ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2015
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 HAWORTH AVE SUITE 270
NEWBERG OR
97132-2093
US
IV. Provider business mailing address
16083 SW UPPER BOONES FERRY RD STE 300
TIGARD OR
97224-7736
US
V. Phone/Fax
- Phone: 503-538-4805
- Fax: 503-538-4878
- Phone: 800-219-8835
- Fax: 503-639-9699
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TODD
GIFFORD
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 800-219-8835