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General NPI Number Information
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NPI Number | 1811292444
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Entity Type | Individual
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Provider Name | MARK HARTFORD P.T.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 7101 NE 137TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98682-4933
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Country | US
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Telephone | 360-418-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 5904 NE 15TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-4941
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Country | US
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Telephone | 323-326-6120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 06498
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60615104
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License Number State | WA
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