Organization Active NPI

Sportscare Integrative Physical Therapy

  • Physical Therapy Clinic/Center
  • Gresham, OR
National Provider Identifier
1548724677
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPORTSCARE INTEGRATIVE PHYSICAL THERAPY
Practice address
24076 SE Stark St Ste 200
Gresham, OR 97030-3376
Phone
(503) 491-1666
Fax
(503) 491-1667
NPI assigned
Jan 23, 2019
Last updated
Jan 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Tomiko Joy Saldia, PT
Title
Part Owner/Operator
Phone
(360) 402-1076

Specialties & licenses 1

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

Addresses

Primary practice location

24076 SE Stark St Ste 200
Gresham, OR 97030-3376

Mailing address

24076 SE Stark St Ste 200
Gresham, OR 97030-3376
Phone (503) 491-1666

Other identifiers 1

IdentifierTypeStateIssuer
500747250MedicaidOR

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1548724677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303376",
            "telephone_number": "503-491-1666",
            "fax_number": "503-491-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303376",
            "telephone_number": "503-491-1666",
            "fax_number": "503-491-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSCARE INTEGRATIVE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "SALDIA",
        "authorized_official_first_name": "TOMIKO",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "PART OWNER/OPERATOR",
        "authorized_official_telephone_number": "360-402-1076",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500747250",
            "state": "OR"
        }
    ],
    "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 Jan 23, 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.

Verify at the official NPI Registry.