Individual provider Active NPI

Lindsay Ann Vondrachek

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1639591159
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60450 Issued in OR
Practice address
6125 SW Boundary
Portland, OR 97221
Phone
(503) 535-4300
Fax
(503) 535-4334
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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 60450 OR Primary

Addresses

Primary practice location

6125 SW Boundary
Portland, OR 97221

Mailing address

4560 SE International Way
Ste. 100
Milwaukie, OR 97222
Phone (971) 206-5200

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60450ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1639591159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "STE. 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 SW BOUNDARY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97221",
            "telephone_number": "503-535-4300",
            "fax_number": "503-535-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDRACHEK",
        "first_name": "LINDSAY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60450",
            "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 Jan 17, 2014; 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.