Everett Nicolai III, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

64923 Issued in OR

Practice address

9735 SW Shady LN Ste 203
Tigard, OR 97223-5481

Phone

(503) 223-1856

Fax

(503) 223-1765

NPI assigned

Oct 3, 2006

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• H & P Goodell, Inc.

  dba Goodell Physical Therapy & Fitness Training

  • Physical Therapy Clinic/Center
  • Portland, OR
  • NPI 1013908169
  Medicare reassignment NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1639263718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 SW SHADY LN STE 203",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235481",
            "telephone_number": "503-223-1856",
            "fax_number": "503-223-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 SW SHADY LN STE 203",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235481",
            "telephone_number": "503-223-1856",
            "fax_number": "503-223-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAI",
        "first_name": "EVERETT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "00010235",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thanh-Truc Nguyen, DMD
• Tony Tu Nguyen, D.M.D.
• Truc Nguyen, FNP-C
• Victoria Nguyen, OD
• Bao Tran Nhan, MD
• Douglas R Niehus, MD
• Enid E Nielsen, MA, LPC, NCC
• Jennifer Ann Nieves, APRN
• Linda Akiko Nishi-Strattner, PH.D., ABPP
• No Worries Corp.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.