NPIMap

Organization Active NPI

Mind Body Therapy

  • Physical Therapy Clinic/Center
  • Portland, OR
National Provider Identifier
1851764906
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MIND BODY THERAPY
Practice address
11959 SW Garden PL
Portland, OR 97223-8249
Phone
(503) 620-0781
Fax
(503) 427-9553
NPI assigned
Nov 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
Rajesh Khemraj, PT
Title
Owner
Phone
(503) 560-4672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

11959 SW Garden PL
Portland, OR 97223-8249

Mailing address

11959 SW Garden PL
Portland, OR 97223-8249
Phone (503) 620-0781

National Provider Directory

National Provider Directory
Tax ID family
Khemraj Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1851764906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11959 SW GARDEN PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238249",
            "telephone_number": "503-620-0781",
            "fax_number": "503-427-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11959 SW GARDEN PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238249",
            "telephone_number": "503-620-0781",
            "fax_number": "503-427-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "KHEMRAJ",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-560-4672",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.