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General NPI Number Information
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NPI Number | 1174442644
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Entity Type | Organization
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Legal Business Name | AS YOU AGE
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 17371 SW GALEWOOD DR
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City | SHERWOOD
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State | OR
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Zip | 97140-7912
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Country | US
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Telephone | 503-482-8502
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Fax |
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Provider Business Mailing Address
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Address Line | 6107 SW MURRAY BLVD # 479
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City | BEAVERTON
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State | OR
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Zip | 97008-4421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER PIDKOWICZ
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Credential | OT
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Telephone | 661-714-4178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number |
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License Number State |
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