Individual provider Active NPI

Kevin Le, DPT

  • Physical Therapist
  • Tigard, OR
National Provider Identifier
1811606908
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64728 Issued in OR
Practice address
11105 SW Greenburg Rd
Tigard, OR 97223-5446
Phone
(971) 294-2669
NPI assigned
Nov 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 64728 OR
Sports Physical Therapist 2251S0007X 64728 OR
Physical Therapist 225100000X 64728 OR Primary

Addresses

Primary practice location

11105 SW Greenburg Rd
Tigard, OR 97223-5446

Mailing address

8824 SW Talawa Dr
Tualatin, OR 97062-6336
Phone (503) 470-0215

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230321003011 OR Practitioner - Physical Therapist in Private Practice 0547634107 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64728ORMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Edge Physical Therapy & Sports Medicine P.C. CurrentSince Jan 25, 2023 Accepting new patients
Pacific Neuro Therapy Physical Therapist CurrentSince Aug 3, 2025 Accepting new patients

Locations

11105 SW Greenburg Rd
Tigard, OR 97223
Phone (971) 294-2669

2020 8th Ave
Ste D
West Linn, OR 97068
Phone (503) 387-5449

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1811606908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8824 SW TALAWA DR",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626336",
            "telephone_number": "503-470-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11105 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235446",
            "telephone_number": "971-294-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KEVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "64728",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "OR",
            "license": "64728",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.