Individual provider Active NPI

Carlee Olson Good, D.P.T.

  • Physical Therapist
  • Lake Oswego, OR
National Provider Identifier
1366635823
Registry record updated Aug 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4448 Issued in OR
Practice address
17360 Holy Names Dr
Building D
Lake Oswego, OR 97034-5133
Phone
(503) 675-2004
Fax
(503) 675-2079
NPI assigned
Aug 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4448 OR Primary

Addresses

Primary practice location

17360 Holy Names Dr
Building D
Lake Oswego, OR 97034-5133

Mailing address

97 Oswego SMT
Lake Oswego, OR 97035-1078
Phone (503) 805-8933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4448ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1187481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187481600000",
    "number": "1366635823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 OSWEGO SMT",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351078",
            "telephone_number": "503-805-8933",
            "fax_number": "503-675-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 HOLY NAMES DR",
            "address_2": "BUILDING D",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345133",
            "telephone_number": "503-675-2004",
            "fax_number": "503-675-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "CARLEE",
        "middle_name": "OLSON",
        "name_prefix": "Mrs.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-19",
        "last_updated": "2007-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2007; 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.