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		OR

General Provider Information

NPI Number	:	1265418628
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	:	503-639-9699

Provider Business Practice Location Address
First Line	:	4876 NW BETHANY BLVD
Second Line	:	SUITE L-1
City	:	PORTLAND
State	:	OR
Zip	:	97229-9259
Country	:	US
Telephone Number	:	503-466-2254
Fax Number	:	503-466-1143

Authorized Official
Title or Position	:	COO
Name	:	MR. TODD ROBERT GIFFORD
Credential	:	PT
Telephone Number	:	503-443-6156

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	10/26/2012

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Directions to “THERAPEUTIC ASSOCIATES INC ” Practice Location

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