Vitality Physical Therapy Northwest LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

VITALITY PHYSICAL THERAPY NORTHWEST LLC

Practice address

12755 SW 69TH Ave
Portland, OR 97223-8373

Phone

(503) 577-2706

NPI assigned

Jan 17, 2018

Organization subpart

No

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

Authorized official

Name

Colleen Gilroy

Title

Owner

Phone

(503) 577-2706

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1144738790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 SE 31ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972028537",
            "telephone_number": "503-577-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 SW 69TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238373",
            "telephone_number": "503-577-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY PHYSICAL THERAPY NORTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "GILROY",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-577-2706"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.