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NPI Code Detail

MEDICARE: RILEY MURRAY PTA

MEDICARE: RILEY MURRAY PTA
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
1225200000XPhysical Therapy Assistant08966OR

General Provider Information

NPI Number : 1336576586
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY MURRAY PTA
Provider Business Mailing Address
First Line : 12948 SE WINSTON RD
Second Line :
City : DAMASCUS
State : OR
Zip : 97089-7606
Country : US
Telephone Number : 503-895-1320
Fax Number : 503-296-2319
Provider Business Practice Location Address
First Line : 7203 SE RAYMOND ST
Second Line :
City : PORTLAND
State : OR
Zip : 97206-4323
Country : US
Telephone Number : 503-895-1320
Fax Number : 503-296-2319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2013
Last Update Date : 10/02/2013

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Directions to “ RILEY MURRAY PTA” Practice Location

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