Individual provider Active NPI

Adam Stadtlander

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1801074679
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60812320 Issued in WA
Practice address
3101 SE 192ND Ave
Vancouver, WA 98683-1442
Phone
(360) 729-8010
Fax
(360) 729-8011
NPI assigned
Feb 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5590 OR
Physical Therapist 225100000X PT60812320 WA Primary

Addresses

Primary practice location

3101 SE 192ND Ave
Vancouver, WA 98683-1442

Mailing address

3600 N Interstate Ave
Portland, OR 97227-1106

Other practice location 1

3600 N Interstate Ave
Portland, OR 97227-1106
Phone (503) 331-3070

Other practice location 2

222 NE Park Plaza Dr Ste 120
Vancouver, WA 98684-5897
Phone (360) 729-8040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250502001677 WA Practitioner - Physical Therapist in Private Practice 1153459086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

505 NE 87TH Ave
Vancouver, WA 98664-1965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5590ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Apr 24, 2025 Accepting new patients
North Lake Physical Therapy and Rehab LP Physical Therapist PastSince Oct 12, 2017 Accepting new patients

Locations

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

222 NE Park Plaza Dr
Ste 120
Vancouver, WA 98684
Phone (360) 253-8285

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

3101 SE 192nd Ave
Vancouver, WA 98683
Phone (360) 729-8010

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1801074679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 192ND AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831442",
            "telephone_number": "360-729-8010",
            "fax_number": "360-729-8011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 N Interstate Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271106",
            "country_code": "US",
            "telephone_number": "503-331-3070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 NE Park Plaza Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986845897",
            "country_code": "US",
            "telephone_number": "360-729-8040",
            "fax_number": "360-729-8041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STADTLANDER",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5590",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60812320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.