MEDICARE: MRS. MARKI M JAMES PT, 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	05229	OR

General Provider Information

NPI Number	:	1629405717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARKI M JAMES PT, DPT

Provider Business Mailing Address
First Line	:	11203 SE SUNNYSIDE RD
Second Line	:
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-7787
Country	:	US
Telephone Number	:	503-698-5500
Fax Number	:	503-698-5501

Provider Business Practice Location Address
First Line	:	11203 SE SUNNYSIDE RD
Second Line	:
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-7787
Country	:	US
Telephone Number	:	503-698-5500
Fax Number	:	503-698-5501

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

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	10/03/2013

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