MEDICARE: THERAPEUTIC ASSOCIATES INC

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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist		WA

General Provider Information

NPI Number	:	1205812062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC ASSOCIATES INC

Provider Business Mailing Address
First Line	:	16083 SW UPPER BOONES FERRY RD
Second Line	:	SUITE 300
City	:	TIGARD
State	:	OR
Zip	:	97224-7736
Country	:	US
Telephone Number	:	800-219-8835
Fax Number	:	503-443-1402

Provider Business Practice Location Address
First Line	:	23505 E APPLEWAY AVE
Second Line	:	STE 106
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-5061
Country	:	US
Telephone Number	:	509-891-2258
Fax Number	:	509-891-2094

Authorized Official
Title or Position	:	DIR PAYER & PROVIDER RELATIONS
Name	:	MELISSA HAMILTON
Credential	:
Telephone Number	:	503-443-6156

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	05/23/2023

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Directions to “THERAPEUTIC ASSOCIATES INC ” Practice Location

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