Active NPI
Damien Alexander Schlobohm, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1548715022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61848
- Practice address
- 6530 SW 30TH Ave
Portland, OR 97239-1007 - Phone
- (503) 244-7533
- NPI assigned
- Aug 24, 2016
- 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 Therapist | 225100000X | 61848 | OR | Primary |
Addresses
Primary practice location
6530 SW 30TH Ave
Portland, OR 97239-1007
Mailing address
2875 NW Stucki Place
Portland, OR 97124
Phone (503) 813-2000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1548715022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2875 NW STUCKI PLACE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97124",
"telephone_number": "503-813-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6530 SW 30TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972391007",
"telephone_number": "503-244-7533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHLOBOHM",
"first_name": "DAMIEN",
"middle_name": "ALEXANDER",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-24",
"last_updated": "2021-03-03",
"certification_date": "2021-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.