North Lake Physical Therapy and Rehabilitation, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.

Practice address

4606 SE Boardman Ave
Milwaukie, OR 97267-5930

Phone

(503) 353-9776

Fax

(503) 353-9777

NPI assigned

Nov 30, 2011

Organization subpart

Yes

Parent organization

NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Choate, MSPT

Title

President, North Lake Physical Ther

Phone

(503) 636-3028

Specialties & licenses 1

Addresses

Other names 1

• Kosta, Choate and Pierson, Inc. Former legal business name

Part of

North Lake PT and Rehab Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1003183302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S STATE ST STE 200G",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343900",
            "telephone_number": "503-636-3028",
            "fax_number": "503-636-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 SE BOARDMAN AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972675930",
            "telephone_number": "503-353-9776",
            "fax_number": "503-353-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH LAKE PHYSICAL THERAPY AND REHABILITATION, INC.",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "CHOATE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT, NORTH LAKE PHYSICAL THER",
        "authorized_official_telephone_number": "503-636-3028",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kosta, Choate and Pierson, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.