Active NPI
Ethan Kameshige
- Physical Therapist
- Beaverton, OR
National Provider Identifier
1730094673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 66154
- Practice address
- 3786 SW Hall Blvd
Beaverton, OR 97005-2050 - Phone
- (503) 883-8633
- NPI assigned
- Aug 17, 2026
- Last updated
- Aug 17, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 66154 | OR | Primary |
Addresses
Primary practice location
3786 SW Hall Blvd
Beaverton, OR 97005-2050
Mailing address
9230 NE Rockspring St Apt A413
Hillsboro, OR 97006-2214
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1730094673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9230 NE ROCKSPRING ST APT A413",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "970062214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3786 SW HALL BLVD",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970052050",
"telephone_number": "503-883-8633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMESHIGE",
"first_name": "ETHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-17",
"last_updated": "2026-08-17",
"certification_date": "2026-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "66154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.