MEDICARE: MOVEMENTX, 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	:	1851858054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOVEMENTX, INC.

Provider Business Mailing Address
First Line	:	1327 SE TACOMA ST UNIT 122
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-6639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5413 CHEYENNE KNOLL PL
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2398
Country	:	US
Telephone Number	:	202-681-1474
Fax Number	:	888-645-6068

Authorized Official
Title or Position	:	COO
Name	:	KEATON ANN RICHARDSON-RAY
Credential	:	PT, DPT
Telephone Number	:	971-361-9442

Provider Enumeration Date	:	02/23/2019
Last Update Date	:	11/12/2025

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