Gwen Marie Hendershot, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5417 Issued in OR

Practice address

1130 NW 22ND Ave Ste 345
Portland, OR 97210-2978

Phone

(503) 413-7513

Fax

(503) 413-7503

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gwen Marie Hendershot Kurilik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Silverton Health

  dba Legacy Woodburn Health Center

  • Rural Health Clinic/Center
  • Woodburn, OR
  • NPI 1679686463
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - Rock Creek

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD (past)
• Therapeutic Associates Inc

  dba TAI NW Portland Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1326023268
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1629275961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 NW NAITO PKWY STE 185",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092535",
            "telephone_number": "503-525-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 345",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102978",
            "telephone_number": "503-413-7513",
            "fax_number": "503-413-7503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 NW Vaughn St",
            "address_2": "Ste 155",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972105311",
            "country_code": "US",
            "telephone_number": "503-227-3479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSHOT",
        "first_name": "GWEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWEN",
            "last_name": "KURILIK",
            "middle_name": "MARIE HENDERSHOT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mekeala Enza Hemming, BEHAVIORAL TECH
• Rosemarie Hemmings, LCSW
• Anna Lee Hemphill, MD
• Melissa Hemphill, MD
• Ashlie Anne Hempstead, ND, LAC
• Alexandra Henderson, LCSW
• Allen Maxwell Henderson
• April Nicole Henderson
• Austin C Henderson, RD
• Beau Henderson

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.