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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1477265072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC ASSOCIATES INC

Provider Business Mailing Address
First Line	:	16083 SW UPPER BOONES FERRY RD STE 300
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97224-7736
Country	:	US
Telephone Number	:	503-443-6156
Fax Number	:

Provider Business Practice Location Address
First Line	:	18910 28TH AVE W
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-4701
Country	:	US
Telephone Number	:	503-443-6156
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TODD GIFFORD
Credential	:
Telephone Number	:	503-443-6156

Provider Enumeration Date	:	12/15/2022
Last Update Date	:	12/15/2022

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Directions to “THERAPEUTIC ASSOCIATES INC ” Practice Location

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