DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: CUSTOM CARE PHYSICAL THERAPY, LLC.

MEDICARE: CUSTOM CARE PHYSICAL THERAPY, LLC.
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
1261QP2000XPhysical Therapy Clinic/Center3440OR
2261QP2000XPhysical Therapy Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508005026
Entity Type Code : Organization
Provider Name (Legal Business Name) : CUSTOM CARE PHYSICAL THERAPY, LLC.
Provider Business Mailing Address
First Line : 3838 PACIFIC AVE
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2224
Country : US
Telephone Number : 503-357-1706
Fax Number : 503-270-5023
Provider Business Practice Location Address
First Line : 3838 PACIFIC AVE
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2224
Country : US
Telephone Number : 503-357-1706
Fax Number : 503-270-5023
Authorized Official
Title or Position : GENERAL MANAGER
Name : LAUREN LEE MASON
Credential :
Telephone Number : 503-357-1706
Provider Enumeration Date : 02/05/2009
Last Update Date : 05/24/2022

Similar Medicare Providers

1003890997 — DR. STEPHEN PATRICK MOON M.D.
Practice Location Address:
3838 PACIFIC AVE
FOREST GROVE, OR
97116-2224
Practice Phone: 503-992-0288
Practice Fax: 503-359-4742
1689650624 — DR. SEAN LINCOLN STEWARD MD
Practice Location Address:
3838 PACIFIC AVE
FOREST GROVE, OR
97116-2224
Practice Phone: 503-992-0288
Practice Fax:
1437197852 — ANDREW J JASZEWSKI PA-C
Practice Location Address:
3838 PACIFIC AVE
FOREST GROVE, OR
97116-2224
Practice Phone: 999-999-9999
Practice Fax:
1679659296 — SEAN L STEWARD, MD, PC
Practice Location Address:
3838 PACIFIC AVE
FOREST GROVE, OR
97116-2224
Practice Phone: 503-992-0288
Practice Fax: 503-359-4724
1548403033 — KERRY JONES ASHBY PA
Practice Location Address:
3838 PACIFIC AVE
FOREST GROVE, OR
97116-2224
Practice Phone: 503-992-0288
Practice Fax:
1154662849 — SEAN L STEWARD, MD, PC
Practice Location Address:
3838 PACIFIC AVE
FOREST GROVE, OR
97116-2224
Practice Phone: 503-992-0288
Practice Fax: 503-359-4724

Directions to “CUSTOM CARE PHYSICAL THERAPY, LLC. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.