Individual provider Active NPI

Sandra Gallagher, PT

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1609405117
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1735 Issued in OR
Practice address
808 SW Campus Dr
Portland, OR 97239-3008
Phone
(503) 418-4500
Fax
(503) 418-4600
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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 1735 OR Primary

Addresses

Primary practice location

808 SW Campus Dr
Portland, OR 97239-3008

Mailing address

3303 SW Bond Ave
Portland, OR 97239-4501
Phone (503) 494-3151

Other practice location 1

3303 SW Bond Ave
Portland, OR 97239-4501
Phone (503) 494-3151

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

LicenseStateTypeSpecialty
1735ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services PastSince Apr 17, 2020 Accepting new patients
University Professional Services PastSince Apr 17, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1609405117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 SW CAMPUS DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393008",
            "telephone_number": "503-418-4500",
            "fax_number": "503-418-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 SW Bond Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972394501",
            "country_code": "US",
            "telephone_number": "503-494-3151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1735",
            "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 Apr 6, 2020; 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.