Andrea Kathryn Kuebbing Mulligan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62722 Issued in OR

Practice address

4560 SE International Way Ste 100
Milwaukie, OR 97222

Phone

(971) 206-5202

NPI assigned

Jan 18, 2012

Sex

Female

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

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Portland Clinic

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1558379099
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1346511649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 SE 43RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153711",
            "telephone_number": "503-960-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9830 NE Cascades Pkwy",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972206832",
            "country_code": "US",
            "telephone_number": "503-575-8325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "ANDREA",
        "middle_name": "KATHRYN KUEBBING",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sakari Kiron Motley, OTR/L
• Anne Marie Mottice, CERTIFIED OCCUPATION
• Manny Moy, DPM
• Sarah A Mrotz, OCCUPATIONAL THERAPI
• Joy Amy Mukai, OTRL
• Wendi Mundy
• Tumaini Munezero
• Naomi Skylark Munichiello, PTA
• Darlene Munoz Valle
• Julie Ann Munson, SPEECH LANGUAGE PATH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.