Healthcare Provider Details

I. General information

NPI: 1114362944
Provider Name (Legal Business Name): VICTORIA BRYSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA LARSON PT

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9265 SW SAPONI LN
TUALATIN OR
97062-8621
US

IV. Provider business mailing address

9265 SW SAPONI LN
TUALATIN OR
97062-8621
US

V. Phone/Fax

Practice location:
  • Phone: 503-507-8570
  • Fax: 971-514-6117
Mailing address:
  • Phone: 503-507-8570
  • Fax: 971-514-6117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number60041
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: