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General NPI Number Information
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NPI Number | 1467006767
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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 | 07/25/2019
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 4677 COMMERCIAL ST SE
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City | SALEM
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State | OR
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Zip | 97302-1901
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Country | US
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Telephone | 503-391-8729
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Fax | 503-588-8629
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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 | 503-443-6156
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Fax | 503-639-9699
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Authorized Official
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Title or Position | CEO
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Name | TODD GIFFORD
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Credential |
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Telephone | 503-443-6156
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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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 |
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License Number State |
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