Roger Miller Lake Oswego Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT0851 Issued in OR

Legal business name

ROGER MILLER LAKE OSWEGO PHYSICAL THERAPY LLC

Practice address

15110 Boones Ferry Rd Ste 230
Lake Oswego, OR 97035-3497

Phone

(971) 204-0600

Fax

(971) 204-0602

NPI assigned

May 18, 2016

Organization subpart

No

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

Authorized official

Name

Roger J Miller, COMP FAAOMPT

Title

Physical Therapist and Owner

Phone

(971) 204-0600

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1760839815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD STE B5",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628859",
            "telephone_number": "971-204-0600",
            "fax_number": "971-204-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15110 BOONES FERRY RD STE 230",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353497",
            "telephone_number": "971-204-0600",
            "fax_number": "971-204-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER MILLER LAKE OSWEGO PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST AND OWNER",
        "authorized_official_telephone_number": "971-204-0600",
        "authorized_official_credential": "COMP FAAOMPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "PT0851",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Christopher Robinson, DMD
• Lee David Robinson, M.D.
• Rick McDonald Robinson, PH.D.
• Daniel Allen Robison, OD
• Rochelle Pegel
• Adonna Rogers
• Billie J Roland, B.S. QMHP
• Andrew Scott Romaine, PA-C
• Noel Romero
• Ronald a Clifton DC Consulting LLC (HealthSource of Lake Oswego)

• Physical Therapy Clinic/Center in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.