Individual provider Active NPI

Ashlee Baltich, PT, DPT

  • Physical Therapist
  • Clackamas, OR
National Provider Identifier
1073172912
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63294 Issued in OR
Practice address
9290 SE Sunnybrook Blvd Ste 230
Clackamas, OR 97015-6777
Phone
(503) 215-2180
NPI assigned
Jun 12, 2019
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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 63294 OR Primary

Addresses

Primary practice location

9290 SE Sunnybrook Blvd Ste 230
Clackamas, OR 97015-6777

Mailing address

9290 SE Sunnybrook Blvd Ste 230
Clackamas, OR 97015-6777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241015002819 OR Practitioner - Physical Therapist in Private Practice 8820520893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KJB Consulting Corporation Physical Therapist CurrentSince Sep 8, 2024 Accepting new patients
Providence Health & Services Oregon Past Accepting new patients

Locations

1427 NW Flanders St
Ste A
Portland, OR 97209
Phone (503) 924-6535

2330 NW Flanders St
Ste G1
Portland, OR 97210
Phone (503) 224-9270

2525 NW Lovejoy St
Ste 202
Portland, OR 97210
Phone (503) 223-3078

9735 SW Shady Ln
Ste 203B
Tigard, OR 97223
Phone (503) 212-4504

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1073172912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 230",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 230",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156777",
            "telephone_number": "503-215-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTICH",
        "first_name": "ASHLEE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.