Active NPI
Angela Audreen Rodriguez, DPT, LMT
- Physical Medicine & Rehabilitation Physician
- Portland, OR
National Provider Identifier
1114090123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 62427
- Practice address
- 8835 SW Canyon LN Ste 302
Portland, OR 97225-3453 - Phone
- (503) 809-2288
- Fax
- (844) 282-0531
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 11252 | OR | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 62427 | OR | Primary |
Addresses
Primary practice location
8835 SW Canyon LN Ste 302
Portland, OR 97225-3453
Mailing address
8835 SW Canyon LN Ste 302
Portland, OR 97225-3453
Phone (503) 809-2288
Other names 1
- Angela Garrison
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250128004587 | OR | Practitioner - Physical Therapist in Private Practice | 0547799009 | Practice locations: Portland, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62427 | OR | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Journey to Health Physical Therapy and Wellness Clinic, LLC | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Portland, OR
- NPI 1124532791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1114090123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8835 SW CANYON LN STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972253453",
"telephone_number": "503-809-2288",
"fax_number": "844-282-0531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8835 SW CANYON LN STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972253453",
"telephone_number": "503-809-2288",
"fax_number": "844-282-0531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ANGELA",
"middle_name": "AUDREEN",
"name_prefix": "Dr.",
"credential": "DPT, LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "11252",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OR",
"license": "62427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "GARRISON",
"credential": "LMT",
"code": "1",
"type": "Former Name"
}
]
}
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 Jan 6, 2025; 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.