Healthcare Provider Details

I. General information

NPI: 1619852753
Provider Name (Legal Business Name): AUBREY CHAMNESS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 HARLOW RD STE 120
SPRINGFIELD OR
97477-1341
US

IV. Provider business mailing address

16083 SW UPPER BOONES FERRY RD
PORTLAND OR
97224-7736
US

V. Phone/Fax

Practice location:
  • Phone: 541-736-8870
  • Fax:
Mailing address:
  • Phone: 503-443-6156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: