Therapeutic Associates Inc
Organization Active NPI Physical Therapist · Wilsonville, OR
NPI 1235575291 · NPPES record last updated May 23, 2023
Key facts
- NPI
- 1235575291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- THERAPEUTIC ASSOCIATES INC
- Practice address
- 29100 SW Town Center Loop W
Suite 190
Wilsonville, OR 97070-9315 - Phone
- (503) 570-7600
- Fax
- (503) 570-7302
- NPI assigned
- May 17, 2013
- Organization subpart
- No
Authorized official
- Name
- Todd Gifford, P.T.
- Title
- Chief Operating Officer
- Phone
- (800) 219-8835
Corporate family (same tax ID) 19
Practitioners 3
-
Laura Eastmond, DPT
-
Jessica Hawley-Gamer, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040205000432 | OR | Part B Supplier - Clinic/Group Practice | 0042116279 |
Receives reassigned benefits from 305 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Sally J Miller PT
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
29100 SW Town Center Loop W
Suite 190
Wilsonville, OR 97070-9315
Mailing address
16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5006603677 | Medicaid | OR |
Other names
- TAI - Wilsonville Physical Therapy
Other providers in Wilsonville, OR
- Ashlea Megan Tenner
- Maddison Terrell
- Eleanor Terry
- Jami Thanos
- The Vascular and Interventional Group, LLC
- Theresa Crumpton Counseling Service, LLC
- Shannon Murphy Thibodeau
- Ashley Jean Thomas
- Nicole Elizabeth Thomas
- Robert Lowell Thomas Jr.
All providers in Wilsonville, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.