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NPI Code Detail

MEDICARE: J AND D PHYSICAL THERAPY SERVICES

MEDICARE: J AND D PHYSICAL THERAPY SERVICES
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 Therapist3362OR
2225100000XPhysical TherapistPT00009469WA
3261QP2000XPhysical Therapy Clinic/Center3362OR

General Provider Information

NPI Number : 1134299951
Entity Type Code : Organization
Provider Name (Legal Business Name) : J AND D PHYSICAL THERAPY SERVICES
Provider Business Mailing Address
First Line : PO BOX 5571
Second Line :
City : PORTLAND
State : OR
Zip : 97228-5571
Country : US
Telephone Number : 503-797-9585
Fax Number : 503-797-0650
Provider Business Practice Location Address
First Line : ONE CENTER COURT
Second Line : SUITE 110
City : PORTLAND
State : OR
Zip : 97227-2104
Country : US
Telephone Number : 503-797-9585
Fax Number : 503-797-0650
Authorized Official
Title or Position : OWNER
Name : MR. DOUGLAS P ROSARIO
Credential : PT
Telephone Number : 503-797-9585
Provider Enumeration Date : 11/09/2006
Last Update Date : 12/03/2007

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1811192131 — MS. SHERYLL LYNN ROSARIO P.T.
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Directions to “J AND D PHYSICAL THERAPY SERVICES ” Practice Location

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