Jack Anderson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

64087 Issued in OR

Practice address

5465 SW Western Ave Ste H
Beaverton, OR 97005-4179

Phone

(503) 610-9281

NPI assigned

May 18, 2021

Last updated

Mar 6, 2025By 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)

Enrolled

Practice roles

Locations

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.

• Go to Ortho LLC

  dba The Injury Clinic

  • Orthopedic Physical Therapist
  • Lake Oswego, OR
  • NPI 1083206155
  NPD
• Headquarters Physical Therapy LLC

  • Physical Therapist
  • Beaverton, OR
  • NPI 1760099725
  NPD

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1205400702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5465 SW WESTERN AVE STE H",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054179",
            "telephone_number": "503-610-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5465 SW WESTERN AVE STE H",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054179",
            "telephone_number": "503-610-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64087",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole C Anderson, FNP
• Christopher Anderson
• Gretchan Anderson
• Helen Marie Anderson, R.N.
• Hope Anderson
• Kyle Edward Anderson, PMHNP-BC
• Mark Alan Anderson, PTA
• Matthew Davis Anderson
• Megan Marie Anderson
• Scott H Anderson, OD

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.