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General NPI Number Information
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NPI Number | 1992572499
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Entity Type | Organization
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Legal Business Name | WHITAKER RESTORATIVE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 813 SW HIGHLAND AVE STE 201
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City | REDMOND
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State | OR
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Zip | 97756-3103
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Country | US
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Telephone | 541-699-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 7848 SW 61ST ST
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City | REDMOND
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State | OR
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Zip | 97756-9424
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Country | US
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Telephone | 541-699-7379
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MARIE WHITAKER
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Credential | PT
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Telephone | 541-699-7379
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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 |
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License Number State |
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