Individual provider Active NPI

Mary-Jean Paulitz, PHYSICAL THERAPIST

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1053427245
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2721 Issued in OR
Practice address
5835 NE 122ND Ave
Suite 135
Portland, OR 97230-1057
Phone
(541) 977-2932
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2721 OR Primary

Addresses

Primary practice location

5835 NE 122ND Ave
Suite 135
Portland, OR 97230-1057

Mailing address

PO Box 17557
Portland, OR 97217-0557
Phone (541) 977-2932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1053427245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17557",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972170557",
            "telephone_number": "541-977-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 NE 122ND AVE",
            "address_2": "SUITE 135",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301057",
            "telephone_number": "541-977-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULITZ",
        "first_name": "MARY-JEAN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2721",
            "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 Sep 13, 2007; 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.