MEDICARE: WRIGLEY MAE CAMPBELL 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	66011	OR

General Provider Information

NPI Number	:	1891641759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WRIGLEY MAE CAMPBELL DPT

Provider Business Mailing Address
First Line	:	12954 SW TEAROSE WAY
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-6686
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15000 SW BARROWS RD STE 201
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-8778
Country	:	US
Telephone Number	:	971-930-4433
Fax Number	:	971-238-2073

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

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/10/2026

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Directions to “ WRIGLEY MAE CAMPBELL DPT” Practice Location

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