Healthcare Provider Details

I. General information

NPI: 1841682556
Provider Name (Legal Business Name): BETHANY MICHELE GEIGER PT, DPT, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETHANY MICHELE LUKENS PT, DPT

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3009
US

IV. Provider business mailing address

481 KAWAIHAE ST
HONOLULU HI
96825-1206
US

V. Phone/Fax

Practice location:
  • Phone: 503-221-3429
  • Fax:
Mailing address:
  • Phone: 808-852-8093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT-4580
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: