Healthcare Provider Details

I. General information

NPI: 1134137847
Provider Name (Legal Business Name): NADIA SEFCOVIC CHOPRA PT, DPT, OCS, COMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3317 NE 15TH AVE
PORTLAND OR
97212
US

IV. Provider business mailing address

3317 NE 15TH AVE
PORTLAND OR
97212-2306
US

V. Phone/Fax

Practice location:
  • Phone: 503-893-9857
  • Fax:
Mailing address:
  • Phone: 718-395-2456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number60990
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: