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General NPI Number Information
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NPI Number | 1306829254
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Entity Type | Individual
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Provider Name | ROGER SCOTT WEGLEY PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 5420 BARNES AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-3839
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Country | US
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Telephone | 206-789-7975
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Fax | 206-782-6177
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Provider Business Mailing Address
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Address Line | 16083 SW UPPER BOONES FERRY RD STE 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 |
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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 | PT00003235
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License Number State | WA
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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 | PT-26 72
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1018
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License Number State | OR
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