Individual provider Active NPI

Mladen Kolundzija, DPT

  • Physical Therapist
  • Milwaukie, OR
National Provider Identifier
1427536747
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62281 Issued in OR
Practice address
10330 SE 32ND Ave
Milwaukie, OR 97222-6587
Phone
(503) 513-8600
NPI assigned
Jul 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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 62281 OR Primary

Addresses

Primary practice location

10330 SE 32ND Ave
Milwaukie, OR 97222-6587

Mailing address

3236 SE Harvey St Apt 33
Milwaukie, OR 97222-6598
Phone (503) 267-4857

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
62281ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1427536747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 SE HARVEY ST APT 33",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226598",
            "telephone_number": "503-267-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 SE 32ND AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226587",
            "telephone_number": "503-513-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLUNDZIJA",
        "first_name": "MLADEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 30, 2018; 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.