NPIMap

Organization Active NPI

Tigard Physical Therapy Inc

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1669449153
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2600 Issued in OR
Legal business name
TIGARD PHYSICAL THERAPY INC
Practice address
12700 SW Pacific Hwy
Portland, OR 97223-6136
Phone
(503) 753-1537
Fax
(503) 573-8004
NPI assigned
Mar 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Lynne R Marshall-BrookNPI 1134196694
Title
President
Phone
(503) 753-1537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2600 OR Primary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 7585 OR
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

12700 SW Pacific Hwy
Portland, OR 97223-6136

Mailing address

PO Box 3728
Tualatin, OR 97062-3728
Phone (503) 753-1537

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706000528 OR Part B Supplier - Clinic/Group Practice 8123005345 Receives reassigned benefits from 3 practitioners
Practice locations: Tigard, OR

National Provider Directory

National Provider Directory

Locations

12700 SW Pacific Hwy
Tigard, OR 97223
Phone (503) 753-1537

18039 SW Lower Boones Ferry Rd
Tigard, OR 97224
Phone (503) 481-4945

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1669449153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3728",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970623728",
            "telephone_number": "503-753-1537",
            "fax_number": "503-573-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SW PACIFIC HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236136",
            "telephone_number": "503-753-1537",
            "fax_number": "503-573-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIGARD PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "MARSHALL-BROOK",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-753-1537"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2600",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "7585",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 15, 2025; 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.