Individual provider Active NPI

Katherine Hamilton, PTA

  • Physical Therapy Assistant
  • Portland, OR
National Provider Identifier
1083121727
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9845 Issued in OR
Practice address
11850 SW 67TH Ave Ste 145
Portland, OR 97223-8961
Phone
(503) 749-9360
NPI assigned
Jan 3, 2018
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA003956 GA
Physical Therapy Assistant 225200000X 9845 OR Primary

Addresses

Primary practice location

11850 SW 67TH Ave Ste 145
Portland, OR 97223-8961

Mailing address

11330 SW Barber St
Wilsonville, OR 97070-7397
Phone (904) 654-7420

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

State licenses

LicenseStateTypeSpecialty
9845ORMDOncology Pharmacist
PTA003956GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mendwell Health LLC Current Accepting new patients

Locations

311 B Ave
Ste L
Lake Oswego, OR 97034
Phone (503) 699-6636

11850 SW 67th Ave
Ste 145
Tigard, OR 97223
Phone (503) 749-9360

Organizations & group practices 1

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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1083121727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 SW BARBER ST",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970707397",
            "telephone_number": "904-654-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 SW 67TH AVE STE 145",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238961",
            "telephone_number": "503-749-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KATHERINE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA003956",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "9845",
            "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 16, 2024; 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.