MEDICARE: PATRICK ANDREW ARVILLE PT

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	64551	OR

General Provider Information

NPI Number	:	1467180513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK ANDREW ARVILLE PT

Provider Business Mailing Address
First Line	:	11635 SE FLAVEL ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-5981
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 S STATE ST STE 4200
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-3977
Country	:	US
Telephone Number	:	503-636-3028
Fax Number	:

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

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	08/08/2022

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Directions to “ PATRICK ANDREW ARVILLE PT” Practice Location

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