Individual provider Active NPI

Stephanie Blank

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1619632395
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
16083 SW Upper Boones Ferry Rd Ste 320
Portland, OR 97224-7736
Phone
(503) 443-6156
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 Primary

Addresses

Primary practice location

16083 SW Upper Boones Ferry Rd Ste 320
Portland, OR 97224-7736

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Portland, OR 97224-7736
Phone (503) 443-6156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211115002608 OR Practitioner - Physical Therapist in Private Practice 3173912060 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16315 SW Barrows Rd
Ste 205
Beaverton, OR 97007
Phone (503) 521-0500

996 NW Circle Blvd
Ste 101
Corvallis, OR 97330
Phone (541) 757-0878

2911 Tennyson Ave
Ste 204
Eugene, OR 97408
Phone (541) 515-6194

702 SW Ramsey Ave
Ste 220
Grants Pass, OR 97527
Phone (541) 479-0765

5955 Shoreview Ln N
Ste 100
Keizer, OR 97303
Phone (503) 463-4221

17355 Boones Ferry Rd
Ste B
Lake Oswego, OR 97035
Phone (503) 635-0844

8028 NE Glisan St
Ste B
Portland, OR 97213
Phone (503) 253-0924

10215 SW Parkway
Ste D
Portland, OR 97225
Phone (503) 292-3583

2040 NW Newcastle St
Roseburg, OR 97471
Phone (541) 673-1808

58147 Columbia River Hwy
Ste A
Saint Helens, OR 97051
Phone (503) 397-1914

20055 SW Pacific Hwy
Ste 110
Sherwood, OR 97140
Phone (503) 625-1691

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

16083 SW Upper Boones Ferry Rd
Ste 320
Tigard, OR 97224
Phone (503) 443-1800

29100 SW Town Center Loop W
Ste 190
Wilsonville, OR 97070
Phone (503) 570-7600

Organizations & group practices 5

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1619632395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.