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General NPI Number Information
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NPI Number | 1245572429
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 3645 EAST OVERLAND RD.
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-888-7765
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Fax | 208-888-7955
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Provider Business Mailing Address
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Address Line | 16083 SW UPPER BOONES FERRY RD SUITE 300
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City | TIGARD
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State | OR
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Zip | 97224-7736
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Country | US
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Telephone | 800-219-8835
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Fax | 503-639-9699
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | TODD GIFFORD
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Credential | P.T
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Telephone | 800-219-8835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational 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 | 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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