Individual provider Active NPI

Emily Nicole Vavrosky, DPT

  • Physical Therapist
  • Gresham, OR
National Provider Identifier
1144779943
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61955 Issued in OR
Practice address
283 NE 223Rd Ave
Gresham, OR 97030-8407
Phone
(503) 912-1192
NPI assigned
Sep 22, 2016
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP035076T WA
Physical Therapist 225100000X 61955 OR Primary
Physical Therapist 225100000X PT.PT.61615153-CP WA

Addresses

Primary practice location

283 NE 223Rd Ave
Gresham, OR 97030-8407

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 702-4389

Other practice location 1

1905 SE 192nd Ave Ste 109
Camas, WA 98607-7415
Phone (360) 210-5440

Other practice location 2

8100 SW Nyberg St
Suite 130
Tualatin, OR 97062-8438
Phone (503) 885-8677

Other practice location 3

1505 NE 40th Ave Ste C
Portland, OR 97232-1861
Phone (503) 210-1425

Other practice location 4

308 N Ivy St
Canby, OR 97013-3704
Phone (503) 263-6786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170220001177 OR Practitioner - Physical Therapist in Private Practice 8426331364 Reassigns benefits to 3 organizations
I20240925003352 WA Practitioner - Physical Therapist in Private Practice 8426331364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Motion PLLCGroup PAC ID 6103071014, 30 clinicians

Practice addresses (Care Compare)

1505 NE 40TH Ave
Suite C
Portland, OR 97232-1861
Phone (503) 210-1425

283 NE 223Rd Ave
Gresham, OR 97030-8407
Phone (503) 912-1192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61955ORMDPhysical Therapist
CP035076TWAMDPhysical Therapist
PT.PT.61615153-CPWAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Proactive LLC Physical Therapist CurrentSince Mar 16, 2020 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Sep 17, 2025 Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Sep 17, 2025 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist Current Accepting new patients
Omnis Omnia Inc. PastSince Feb 4, 2015 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

308 N Ivy St
Canby, OR 97013
Phone (503) 263-6786

1777 Coburg Rd
Ste 3
Eugene, OR 97401
Phone (541) 505-8041

1480 NE Village St
Fairview, OR 97024
Phone (503) 489-1174

440 1st St
Lake Oswego, OR 97034
Phone (503) 744-4826

3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

1630 Beavercreek Rd
Ste A
Oregon City, OR 97045
Phone (503) 607-0047

450 NW Greenwood Ave
Redmond, OR 97756
Phone (541) 923-0410

365 Westfield St
Silverton, OR 97381
Phone (503) 873-6111

19767 SW 72nd Ave
Ste 105
Tualatin, OR 97062
Phone (503) 454-0526

Organizations & group practices 7

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": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1144779943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-702-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 NE 223RD AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308407",
            "telephone_number": "503-912-1192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 SE 192nd Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986077415",
            "country_code": "US",
            "telephone_number": "360-210-5440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8100 SW Nyberg St",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970628438",
            "country_code": "US",
            "telephone_number": "503-885-8677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 NE 40th Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972321861",
            "country_code": "US",
            "telephone_number": "503-210-1425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 N Ivy St",
            "address_purpose": "LOCATION",
            "city": "Canby",
            "state": "OR",
            "postal_code": "970133704",
            "country_code": "US",
            "telephone_number": "503-263-6786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAVROSKY",
        "first_name": "EMILY",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "CP035076T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61955",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT.PT.61615153-CP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.