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General NPI Number Information
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NPI Number | 1477084549
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Entity Type | Organization
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Legal Business Name | PHYSIO PDX LLC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 2250 NW FLANDERS ST STE G1
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City | PORTLAND
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State | OR
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Zip | 97210-3475
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Country | US
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Telephone | 503-847-8550
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Fax | 971-213-4030
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Provider Business Mailing Address
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Address Line | 2250 NW FLANDERS ST STE G1
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City | PORTLAND
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State | OR
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Zip | 97210-3475
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Country | US
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Telephone | 503-847-8550
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Fax | 971-213-4030
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | SARAH H STUHR
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Credential | PT, DPT
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Telephone | 503-847-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 60490
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License Number State | OR
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