MEDICARE: NEW HEIGHTS INTEGRATIVE THERAPY, 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	:	1922126937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HEIGHTS INTEGRATIVE THERAPY, INC.

Provider Business Mailing Address
First Line	:	1700 BROADWAY ST
Second Line	:	SUITE 101
City	:	VANCOUVER
State	:	WA
Zip	:	98663-3455
Country	:	US
Telephone Number	:	360-737-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 BROADWAY ST
Second Line	:	SUITE 101
City	:	VANCOUVER
State	:	WA
Zip	:	98663-3455
Country	:	US
Telephone Number	:	360-737-3346
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KEVIN EUGENE POE
Credential	:
Telephone Number	:	503-236-3108

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	12/11/2020

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