Brian T Sundahl, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5367 Issued in OR

Practice address

19856 SE Highway 212
Damascus, OR 97089-5743

Phone

(417) 559-2627

Fax

(503) 386-2745

NPI assigned

Jun 16, 2006

Last updated

Sep 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OR, MO2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Physical Therapy IncGroup PAC ID 1153427067, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Endeavor Physical Therapy, Inc.

  • Physical Therapist
  • Damascus, OR
  • NPI 1457577553
  Medicare reassignment Care Compare group Authorized official
• Olympic Sports and Spine Rehabilitation PS

  • Physical Therapist
  • Puyallup, WA
  • NPI 1558310375
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1790729952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 SOUTH BROADWAY",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "97023",
            "telephone_number": "503-630-5314",
            "fax_number": "503-630-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19856 SE HIGHWAY 212",
            "city": "DAMASCUS",
            "state": "OR",
            "postal_code": "970895743",
            "telephone_number": "417-559-2627",
            "fax_number": "503-386-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDAHL",
        "first_name": "BRIAN",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008548",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS PROGRAM",
            "identifier": "8930584",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "151355",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8347015",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "5743SU",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Jo Scott, LAC
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• Joanne E Serna, LCSW
• Sarah Smyly
• Melanie Swallow
• Thomas Dutcher D.C., P.C. Inc. (Sunrise Chiropractic)
• Abigail Elizabeth Tolomei Barcenas, MS, CF-SLP
• Brett N Touchette, RPH, CGP
• Danny Tran

• Physical Therapist in Damascus, OR
• Providers in Damascus, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.