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General NPI Number Information
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NPI Number | 1598575102
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Entity Type | Organization
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Legal Business Name | WALSH PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 710 NE HOLLADAY ST # 150
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City | PORTLAND
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State | OR
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Zip | 97232-2168
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Country | US
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Telephone | 503-542-2744
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Fax |
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Provider Business Mailing Address
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Address Line | 710 NE HOLLADAY ST # 150
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City | PORTLAND
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State | OR
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Zip | 97232-2168
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Country | US
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Telephone | 503-542-2744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW WALSH
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Credential | PT
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Telephone | 503-887-2825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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