Active NPI
Eric Drake, DPT
- Physical Medicine & Rehabilitation Physician
- Dallas, OR
National Provider Identifier
1497300164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 2292
- Practice address
- 210 W Ellendale Ave Ste 100
Dallas, OR 97338-1790 - Phone
- (503) 623-2433
- Fax
- (503) 623-2196
- NPI assigned
- Aug 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 2292 | ND | Primary |
Addresses
Primary practice location
210 W Ellendale Ave Ste 100
Dallas, OR 97338-1790
Mailing address
4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone (503) 390-9009
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2292 | ND | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1497300164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 CHERRY AVE NE",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034859",
"telephone_number": "503-390-9009",
"fax_number": "503-623-2196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W ELLENDALE AVE STE 100",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381790",
"telephone_number": "503-623-2433",
"fax_number": "503-623-2196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "ERIC",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-08",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "ND",
"license": "2292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.