MEDICARE: ELIZABETH A BLACK BS PT

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	4462	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1932179025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A BLACK BS PT

Provider Business Mailing Address
First Line	:	6954 NE DAVIS ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213
Country	:	US
Telephone Number	:	503-235-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	7927 SE ORIENT DR
Second Line	:
City	:	GRESHAM
State	:	OR
Zip	:	97080
Country	:	US
Telephone Number	:	503-663-0332
Fax Number	:	503-663-1114

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1174997423 — VALLEYVIEW INJURY & PHYSICAL MEDICINE, PC
Practice Location Address:

2850 SE POWELL VALLEY RD , SUITE 205
GRESHAM, OR
97080-1494

Practice Phone: 503-489-1998
Practice Fax: 503-489-1975

1922966142 — DAMARIS ABIGAIL POP PA
Practice Location Address:

3409 SW 30TH ST
GRESHAM, OR
97080-9423

Practice Phone: 503-847-1859
Practice Fax:

1184027997 — LAUREN SCHMIDT MA, ATR, LPC
Practice Location Address:

581 SW 4TH ST
GRESHAM, OR
97080-5209

Practice Phone: 312-315-3376
Practice Fax:

1740149772 — METRO TREATMENT OF OREGON LP
Practice Location Address:

2222 E POWELL BLVD
GRESHAM, OR
97080-1365

Practice Phone: 971-360-0272
Practice Fax: 971-360-0273

1336128321 — URGENT CARE NW GRESHAM PC
Practice Location Address:

2850 SE POWELL VALLEY RD
GRESHAM, OR
97080

Practice Phone: 503-666-5050
Practice Fax: 503-666-7410

1871563783 — TARA G MCCANN MSOT
Practice Location Address:

7927 SE ORIENT DR
GRESHAM, OR
97080

Practice Phone: 503-663-0332
Practice Fax: 503-663-1114

Directions to “ ELIZABETH A BLACK BS PT” 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.