Riley Eugene Enberg

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P161441541 Issued in WA

Practice address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

Phone

(971) 364-0611

Fax

(971) 364-0610

NPI assigned

Jun 9, 2021

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1174190953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW STE 102",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663094",
            "telephone_number": "206-535-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "971-364-0611",
            "fax_number": "971-364-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENBERG",
        "first_name": "RILEY",
        "middle_name": "EUGENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA28243",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161441541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klara Louise Ecklund, L.M.T.
• Elisa Herrman DMD LLC (Wilsonville Orthodontics)
• Elysium Health Cooperative (Ehco)
• Emeritus Corporation (Brookdale Wilsonville)
• Empowerme Rehabilitation, LLC
• Armasabille Navalon Ermita, MD
• Tim David Esau, MSPT
• Jessica Joanne Etcheberry, LICSW
• Patrick Evangelista
• Brenda Evans, CSWA

• Physical Therapy Assistant in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.