Proactive Physical Therapy Tualatin

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROACTIVE PHYSICAL THERAPY TUALATIN

Practice address

19255 SW 65TH Ave
Suite 250
Tualatin, OR 97062-7451

Phone

(503) 545-0526

Fax

(503) 855-4568

NPI assigned

May 27, 2015

Organization subpart

No

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

Authorized official

Name

Michelle McCall

Title

Billing Director / Credentialing

Phone

(503) 489-6250

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1003295775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 NE VILLAGE ST",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970243827",
            "telephone_number": "503-489-6250",
            "fax_number": "503-489-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19255 SW 65TH AVE",
            "address_2": "SUITE 250",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627451",
            "telephone_number": "503-545-0526",
            "fax_number": "503-855-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY TUALATIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING DIRECTOR / CREDENTIALING",
        "authorized_official_telephone_number": "503-489-6250"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.