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General NPI Number Information
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NPI Number | 1497172373
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Entity Type | Organization
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Legal Business Name | KJB CONSULTING CORPORATION
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2525 NW LOVEJOY ST STE 202
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City | PORTLAND
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State | OR
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Zip | 97210-2863
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Country | US
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Telephone | 503-223-1856
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Fax | 503-223-1765
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Provider Business Mailing Address
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Address Line | 2525 NW LOVEJOY ST STE 202
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City | PORTLAND
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State | OR
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Zip | 97210-2863
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Country | US
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Telephone | 503-223-1856
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRYAN LANG
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Credential | DPT
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Telephone | 503-223-1856
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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 | 60504
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 61700
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 06391
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 05662
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 60214
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License Number State | OR
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