Lifestyles Physical Therapy, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1369712-7 Issued in OR

Legal business name

LIFESTYLES PHYSICAL THERAPY, PC

Practice address

4445 SW Barbur Blvd.
Suite 204
Portland, OR 97239

Phone

(503) 235-3386

Fax

(503) 239-1694

NPI assigned

Feb 5, 2009

Organization subpart

No

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

Authorized official

Name

Kelly Stott Campbell, PT

Title

President

Phone

(503) 235-3386

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Nelson, MSPT, OCS

  • Orthopedic Physical Therapist
  • Portland, OR
  • NPI 1053353904
  NPD (past)

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1013156603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 SW BARBUR BLVD.",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-235-3386",
            "fax_number": "503-239-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 SW BARBUR BLVD.",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-235-3386",
            "fax_number": "503-239-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLES PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "STOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-235-3386",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "1369712-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Works Northwest
• Lifekey Counseling
• Lifelong Learning LLC (Lifelong learning)
• Lifelong Wellness Center, LLC
• Lifesmile Dental Group
• Lifetime Optimization, Inc.
• Lifeweighs (LifeWeighs LLC)
• Lifeworks Northwest
• Lifeworks Northwest
• Lifeworks Northwest

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.