Organization Active NPI

Ipa Physio Portland LLC

  • Physical Therapy Clinic/Center
  • Portland, OR
National Provider Identifier
1063921187
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
05926 Issued in OR
Legal business name
IPA PHYSIO PORTLAND LLC
Practice address
7412 SW Beaverton Hillsdale Hwy Ste 110
Portland, OR 97225-2167
Phone
(503) 616-0313
NPI assigned
Sep 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Kristin Foster
Title
Office Administrator
Phone
(503) 616-0313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X 05926 OR Primary

Addresses

Primary practice location

7412 SW Beaverton Hillsdale Hwy Ste 110
Portland, OR 97225-2167

Mailing address

7412 SW Beaverton Hillsdale Hwy Ste 110
Portland, OR 97225-2167
Phone (503) 616-0313

National Provider Directory

National Provider Directory

Locations

7412 SW Beaverton Hillsdale Hwy
Ste 110
Portland, OR 97225
Phone (503) 616-0313

1820 SW Vermont St
Ste F
Portland, OR 97219
Phone (503) 201-8333

Practitioners & affiliated clinicians

Practitioners 3

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": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1063921187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7412 SW BEAVERTON HILLSDALE HWY STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252167",
            "telephone_number": "503-616-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7412 SW BEAVERTON HILLSDALE HWY STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252167",
            "telephone_number": "503-616-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPA PHYSIO PORTLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "503-616-0313"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "05926",
            "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 Feb 20, 2025; 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.