Healthcare Provider Details
I. General information
NPI: 1265791560
Provider Name (Legal Business Name): THERAPEUTIC ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2012
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
207 PHYSICAL EDUCATION BUILDING
CHENEY WA
99004-2476
US
IV. Provider business mailing address
16083 SW UPPER BOONES FERRY RD SUITE 300
TIGARD OR
97224-7736
US
V. Phone/Fax
- Phone: 509-466-4379
- Fax: 509-466-4407
- Phone: 800-219-8835
- Fax: 503-639-9699
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELISSA
HAMILTON
Title or Position: DIR PAYER & PROVIDER RELATIONS
Credential:
Phone: 503-443-6156