Titan Physical Therapy Services, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

06984 Issued in OR

Legal business name

TITAN PHYSICAL THERAPY SERVICES, LLC

Doing business as

Physical Therapy at the MAC

Practice address

1849 SW Salmon St
Portland, OR 97205-1726

Phone

(503) 519-0011

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

Jay Brent Jensen, PT, ATC

Title

Owner

Phone

(503) 519-0011

Specialties & licenses 1

Addresses

Other names 1

• Physical Therapy at the MAC Doing business as

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1902253008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16623 SW OYSTERCATCHER LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078706",
            "telephone_number": "503-519-0011",
            "fax_number": "503-590-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SW SALMON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051726",
            "telephone_number": "503-519-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN PHYSICAL THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-519-0011",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": "06984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy at the MAC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hollie N Tirrell, ATC, CKTP
• Nagendra Ranganatha Rao Tirumali, M.D.
• Miya Tischler
• Angela Lee Tisci, LAC
• Sallie Tisdale, RN
• Melisa Suzanne Titan, B.S
• Valerie L. Titan, RN
• Lauren Mary Titchener, MD
• Robert L Titchener, PA
• Meredith Vanderhorst Tittler, PH.D.

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, 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 May 18, 2016; 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.