Individual provider Active NPI

Lucy Dahl, PT, DPT

  • Geriatric Physical Therapist
  • Milwaukie, OR
National Provider Identifier
1326312414
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
61283294 Issued in WA
Practice address
4560 SE International Way Ste 101
Milwaukie, OR 97222-4628
Phone
(971) 206-5202
NPI assigned
Mar 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 60220 OR
Geriatric Physical Therapist 2251G0304X 61283294 WA Primary

Addresses

Primary practice location

4560 SE International Way Ste 101
Milwaukie, OR 97222-4628

Mailing address

219 133Rd St SE
Everett, WA 98208-6409
Phone (810) 513-2792

Other practice location 1

2350 Limon Dr
Fort Collins, CO 80525-7622
Phone (970) 224-2700

Other names 1

  • Lucy Dahl Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021001840 CA Practitioner - Physical Therapist in Private Practice 6305070327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 Emeryville Dr
Suite 320
Cranberry Township, PA 16066-5023

219 133Rd St SE
Everett, WA 98208-6409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61283294WAMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Aug 4, 2025 Accepting new patients

Locations

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1326312414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 133RD ST SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086409",
            "telephone_number": "810-513-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 101",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 Limon Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805257622",
            "country_code": "US",
            "telephone_number": "970-224-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "LUCY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "OR",
            "license": "60220",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WA",
            "license": "61283294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "DAHL",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.