NPIMap

Organization Active NPI

Pacific Crest Physical Therapy Inc

  • Physical Therapist
  • Warrenton, OR
National Provider Identifier
1255413787
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PACIFIC CREST PHYSICAL THERAPY INC
Practice address
25 N. Hwy 101
Warrenton, OR 97146
Phone
(503) 861-3550
Fax
(503) 861-3559
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Victoria M. Vestal, LPTNPI 1922198662
Title
Owner Administrator
Phone
(503) 861-3550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

25 N. Hwy 101
Warrenton, OR 97146

Mailing address

PO Box 8
Warrenton, OR 97146-0008
Phone (503) 861-3550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000849 OR Part B Supplier - Clinic/Group Practice 3173414091 Receives reassigned benefits from 1 practitioner
Practice locations: Warrenton, OR

National Provider Directory

National Provider Directory

Locations

25 N Highway 101
Warrenton, OR 97146
Phone (503) 861-3550

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255413787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971460008",
            "telephone_number": "503-861-3550",
            "fax_number": "503-861-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N. HWY 101",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "97146",
            "telephone_number": "503-861-3550",
            "fax_number": "503-861-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CREST PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VESTAL",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "503-861-3550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.