Jennifer Porter Hassibi, PHYSICAL THERAPIST

Individual provider Active NPI Physical Therapist · Milwaukee, OR

NPI 1902986409 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1902986409
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1136521 (TX)
Practice address
4560 SE International Way
Consonus Rehab Services
Milwaukee, OR 97222
Phone
(971) 206-5140
Fax
(971) 206-5209
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1136521TXMDCertified Registered Nurse Anesthetist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1136521 TX Yes

Addresses

Primary practice location

4560 SE International Way
Consonus Rehab Services
Milwaukee, OR 97222

Mailing address

4560 SE International Way
Milwaukee, OR 97222
Phone (971) 206-5140

Other names

  • Jennifer Lynn Porter Former name

Other providers in Milwaukee, OR

All providers in Milwaukee, OR · Physical Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.