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General NPI Number Information
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NPI Number | 1376443127
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Entity Type | Organization
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Legal Business Name | PEAK PERFORMANCE THERAPY LLC
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 16083 SW UPPER BOONES FERRY RD STE 130
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City | TIGARD
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State | OR
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Zip | 97224-7737
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Country | US
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Telephone | 907-957-2426
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Fax |
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Provider Business Mailing Address
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Address Line | 5441 S MACADAM AVE STE R
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City | PORTLAND
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State | OR
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Zip | 97239-3822
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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 | VICTOR WILSON
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Credential | DPT
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Telephone | 907-957-2426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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