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General NPI Number Information
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NPI Number | 1235882184
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Entity Type | Individual
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Provider Name | KEVIN TOKOPH PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 25500 SE STARK ST STE 103
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City | GRESHAM
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State | OR
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Zip | 97030-8327
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Country | US
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Telephone | 503-328-0222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 578
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City | TROUTDALE
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State | OR
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Zip | 97060-0578
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Country | US
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Telephone | 503-489-1174
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 64363
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License Number State | OR
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