MEDICARE: NADIA SEFCOVIC CHOPRA PT, DPT, OCS, COMT

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
1	2251X0800X	Orthopedic Physical Therapist	60990	OR

General Provider Information

NPI Number	:	1134137847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA SEFCOVIC CHOPRA PT, DPT, OCS, COMT

Provider Business Mailing Address
First Line	:	3317 NE 15TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-2306
Country	:	US
Telephone Number	:	718-395-2456
Fax Number	:

Provider Business Practice Location Address
First Line	:	3317 NE 15TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212
Country	:	US
Telephone Number	:	503-893-9857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/08/2018

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