Healthcare Provider Details

I. General information

NPI: 1497822183
Provider Name (Legal Business Name): EAST CASCADE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W 4TH ST
THE DALLES OR
97058-1803
US

IV. Provider business mailing address

115 W 4TH ST
THE DALLES OR
97058-1803
US

V. Phone/Fax

Practice location:
  • Phone: 541-298-8985
  • Fax:
Mailing address:
  • Phone: 541-298-8985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD MILLER
Title or Position: CO OWNER
Credential:
Phone: 541-298-8985