MEDICARE: JONATHAN RICE DPT

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	225100000X	Physical Therapist	60306	OR

General Provider Information

NPI Number	:	1457784779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN RICE DPT

Provider Business Mailing Address
First Line	:	16126 SE HAPPY VALLEY TOWN CENTER DR STE 200
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-4256
Country	:	US
Telephone Number	:	503-427-0118
Fax Number	:

Provider Business Practice Location Address
First Line	:	16126 SE HAPPY VALLEY TOWN CENTER DR STE 200
Second Line	:
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-4256
Country	:	US
Telephone Number	:	503-427-0118
Fax Number	:

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

Provider Enumeration Date	:	08/11/2013
Last Update Date	:	12/13/2016

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Directions to “ JONATHAN RICE DPT” Practice Location

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