Individual provider Active NPI

Dennis Herman Eaton, P.T.

  • Physical Therapist
  • Portland, OR
National Provider Identifier
1700914678
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1895 Issued in OR
Practice address
2442 SE 101St Ave
Suite 307
Portland, OR 97216-3060
Phone
(503) 235-5500
Fax
(503) 595-0454
NPI assigned
Mar 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1895 OR Primary

Addresses

Primary practice location

2442 SE 101St Ave
Suite 307
Portland, OR 97216-3060

Mailing address

2442 SE 101St Ave
Suite 307
Portland, OR 97216-3060
Phone (503) 235-5500

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1895ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700914678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 SE 101ST AVE",
            "address_2": "SUITE 307",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163060",
            "telephone_number": "503-235-5500",
            "fax_number": "503-595-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 SE 101ST AVE",
            "address_2": "SUITE 307",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163060",
            "telephone_number": "503-235-5500",
            "fax_number": "503-595-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "DENNIS",
        "middle_name": "HERMAN",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1895",
            "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 Jul 8, 2007; 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.