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NPI Code Detail

MEDICARE: KRISTEN TERVO PT

MEDICARE: KRISTEN TERVO PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist8072OH
2225100000XPhysical Therapist63073OR

General Provider Information

NPI Number : 1063474641
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN TERVO PT
Provider Business Mailing Address
First Line : 12123 SW 69TH AVE
Second Line :
City : TIGARD
State : OR
Zip : 97223-8514
Country : US
Telephone Number : 971-708-7600
Fax Number :
Provider Business Practice Location Address
First Line : 12123 SW 69TH AVE
Second Line :
City : TIGARD
State : OR
Zip : 97223-8514
Country : US
Telephone Number : 717-087-6009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 01/10/2022

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Directions to “ KRISTEN TERVO PT” Practice Location

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