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General NPI Number Information
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NPI Number | 1114335403
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Entity Type | Individual
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Provider Name | DUNCAN THOMAS MITCHELL PT
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Gender | Male
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | MITCHELL PHYSICAL THERAPY 4506 SE KING ROAD
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City | MILWAUKIE
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State | OR
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Zip | 97222-5233
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Country | US
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Telephone | 503-496-4550
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Fax | 503-496-4551
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Provider Business Mailing Address
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Address Line | 4506 SE KING ROAD
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City | MILWAUKIE
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State | OR
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Zip | 97222-5233
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Country | US
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Telephone | 503-496-4550
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Fax | 503-496-4551
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 41456
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 61879
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License Number State | OR
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