Brian Edward Anderson, MPT

Individual provider Active NPI Physical Therapist · Milwaukie, OR

NPI 1235319641 · NPPES record last updated Nov 14, 2007

Key facts

NPI
1235319641
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1296 (NV)
Practice address
4560 SE International Way
Suite 100 Consonus Healthcare Services
Milwaukie, OR 97222
Phone
(971) 206-5149
Fax
(971) 206-5209
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1296NVMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1296 NV Yes

Addresses

Primary practice location

4560 SE International Way
Suite 100 Consonus Healthcare Services
Milwaukie, OR 97222

Mailing address

4560 SE International Way
Suite 100 Consonus Healthcare Services
Milwaukie, OR 97222
Phone (971) 206-5149

Other providers in Milwaukie, OR

All providers in Milwaukie, OR · Physical Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.