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General NPI Number Information
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NPI Number | 1760841308
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Entity Type | Organization
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Legal Business Name | GEORGE FOX UNIVERSITY PHYSICAL THERAPY COMMUNITY CLINIC
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 448 N WERTH BLVD
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City | NEWBERG
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State | OR
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Zip | 97132-7500
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Country | US
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Telephone | 503-554-2479
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Fax | 503-554-3918
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Provider Business Mailing Address
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Address Line | 448 N WERTH BLVD
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City | NEWBERG
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State | OR
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Zip | 97132-7500
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Country | US
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Telephone | 503-554-2479
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Fax | 503-554-3918
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Authorized Official
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Title or Position | DIRECTOR OF CLINIC
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Name | JAYDEE R ROMICK
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Credential | DPT
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Telephone | 503-901-3865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2213
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License Number State | OR
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