Laila Deardorff, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3638 Issued in OR

Practice address

17079 Canal Cir
Lake Oswego, OR 97035-5613

Phone

(503) 267-8952

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Stark PT Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1841460052
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1366478299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17079 CANAL CIR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355613",
            "telephone_number": "503-267-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17079 CANAL CIR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355613",
            "telephone_number": "503-267-8952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3903 SW Kelly Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972394385",
            "country_code": "US",
            "telephone_number": "503-223-8157",
            "fax_number": "503-248-4730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARDORFF",
        "first_name": "LAILA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tierra Davis
• Jonah Day
• Chantelle De Jager
• Victoria Alysse De la Llama, LCSW
• Nancy Lynn De Turk, LMT
• Isabel Deaver, LPC
• Kim Deaver, ATC
• Eleanor B Debakker, PT
• Deborah Mertlich, LCSW
• Samantha Dela Cruz

• Physical Therapist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.