NPIMap

Organization Active NPI

Gresham Sportscare

  • Physical Therapy Clinic/Center
  • Gresham, OR
National Provider Identifier
1487789657
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1517 Issued in OR
Legal business name
GRESHAM SPORTSCARE
Practice address
24076 SE Stark St
Ste. 200
Gresham, OR 97030-3373
Phone
(503) 491-1666
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Authorized official

Name
Mr. C. George Eischen Jr., PT
Title
Director
Phone
(503) 491-1666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1517 OR Primary

Addresses

Primary practice location

24076 SE Stark St
Ste. 200
Gresham, OR 97030-3373

Mailing address

24076 SE Stark St
Ste. 200
Gresham, OR 97030-3373
Phone (503) 491-1666

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1487789657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "STE. 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-491-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "STE. 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-491-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRESHAM SPORTSCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "EISCHEN",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "503-491-1666",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "1517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.