Organization Active NPI

Funkxn LLC

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
National Provider Identifier
1023998176
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
FUNKXN LLC
Practice address
710 NE Holladay St Ste 150
Portland, OR 97232-2168
Phone
(503) 542-2744
Fax
(877) 773-0291
NPI assigned
Sep 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Leo Donlea
Title
General Manager
Phone
(206) 963-3589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

710 NE Holladay St Ste 150
Portland, OR 97232-2168

Mailing address

710 NE Holladay St Ste 150
Portland, OR 97232-2168
Phone (503) 542-2744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260526003540 OR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7012487531 Receives reassigned benefits from 4 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

710 NE Holladay St
Ste 150
Portland, OR 97232
Phone (503) 542-2744

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1023998176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 NE HOLLADAY ST STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322168",
            "telephone_number": "503-542-2744",
            "fax_number": "877-773-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NE HOLLADAY ST STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322168",
            "telephone_number": "503-542-2744",
            "fax_number": "877-773-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNKXN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "DONLEA",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "206-963-3589"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.